This provider averages 108 services per working day
Based on 269.0K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $26.1M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 108 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 242% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.
| Year | Avg Submitted | Avg Paid | Markup Ratio | Gap per Service | Total Payments | Services | Beneficiaries |
|---|---|---|---|---|---|---|---|
| 2014 | $318.32 | $66.85 | 4.76x | $251.47 | $1.1M | 16.0K | 30 |
| 2015 | $275.75 | $74.41 | 3.71x | $201.34 | $1.4M | 19.5K | 32 |
| 2016 | $264.64 | $74.67 | 3.54x | $189.97 | $1.7M | 22.7K | 36 |
| 2017 | $277.10 | $80.64 | 3.44x | $196.46 | $1.9M | 24.0K | 36 |
| 2018 | $288.76 | $92.14 | 3.13x | $196.62 | $2.5M | 27.5K | 34 |
| 2019 | $284.97 | $101.57 | 2.81x | $183.40 | $3.1M | 30.3K | 33 |
| 2020 | $287.38 | $104.09 | 2.76x | $183.29 | $3.3M | 31.3K | 32 |
| 2021 | $311.41 | $117.08 | 2.66x | $194.33 | $3.8M | 32.6K | 35 |
| 2022 | $319.62 | $117.93 | 2.71x | $201.69 | $3.6M | 30.9K | 34 |
| 2023 | $281.60 | $106.93 | 2.63x | $174.67 | $3.7M | 34.1K | 32 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 11.8K | $8.5M | $725.71 | 1.36x |
| J2778 | Injection, ranibizumab, 0.1 mg | 21.1K | $5.4M | $258.46 | 2.27x |
| 67028 | Injection of drug into eye | 36.8K | $2.8M | $75.16 | 6.97x |
| 92134 | Imaging of retina | 50.6K | $1.5M | $29.78 | 3.28x |
| 66984 | Removal of cataract with insertion of prosthetic lens | 3.3K | $1.0M | $312.92 | 6.27x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 12.3K | $1.0M | $81.16 | 1.81x |
| J3590 | Unclassified biologics | 22.0K | $880.8K | $40.10 | 4.28x |
| 66821 | Removal of recurring cataract in lens capsule using a laser | 3.1K | $696.8K | $228.00 | 5.43x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 6.3K | $512.4K | $81.60 | 1.66x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 1.5K | $494.0K | $324.81 | 5.62x |
| 66982 | Complex removal of cataract with insertion of prosthetic lens | 913 | $400.7K | $438.87 | 5.14x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 3.5K | $325.5K | $93.47 | 4.81x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 2.9K | $310.5K | $106.40 | 1.93x |
| 67210 | Destruction of growth of retina using a laser | 846 | $305.1K | $360.61 | 2.89x |
| J0585 | Injection, onabotulinumtoxina, 1 unit | 57.9K | $274.9K | $4.75 | 1.60x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 6.0K | $174.6K | $29.09 | 1.45x |
| 92250 | Photography of the retina | 4.0K | $148.3K | $36.91 | 2.87x |
| 92136 | Measurement of corneal curvature and depth of eye | 3.3K | $131.8K | $39.56 | 4.04x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 523 | $127.2K | $243.29 | 2.79x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 2.5K | $125.9K | $50.47 | 1.68x |
This provider submits charges 3 times higher than what Medicare actually pays.
A markup ratio of 3x means for every $100 Medicare pays, this provider initially charges $300. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Other Ophthalmology providers in IN for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Drew Sommerville, MD | Evansville, IN | $35.4M | ✓ Clear |
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Last Updated: February 2026 (data through 2023, the latest CMS release)
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.
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