This provider's $21.6M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 394% from 2014 to 2023.
80% of their billing comes from a single procedure code (J0178 — Injection, aflibercept, 1 mg).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 122% in 2020
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 | $517.87 | $204.35 | 2.53x | $313.52 | $774.7K | 3.8K | 14 |
| 2015 | $494.78 | $202.35 | 2.45x | $292.43 | $771.2K | 3.8K | 13 |
| 2016 | $476.10 | $188.66 | 2.52x | $287.44 | $841.6K | 4.5K | 15 |
| 2017 | $523.07 | $210.91 | 2.48x | $312.16 | $1.0M | 4.8K | 18 |
| 2018 | $495.96 | $210.26 | 2.36x | $285.70 | $1.1M | 5.0K | 15 |
| 2019 | $738.78 | $250.50 | 2.95x | $488.28 | $1.5M | 5.9K | 16 |
| 2020 | $1.1K | $308.53 | 3.72x | $838.08 | $3.3M | 10.6K | 12 |
| 2021 | $1.2K | $323.87 | 3.69x | $871.08 | $4.4M | 13.6K | 15 |
| 2022 | $1.2K | $321.77 | 3.81x | $904.67 | $4.2M | 12.9K | 11 |
| 2023 | $666.26 | $183.71 | 3.63x | $482.55 | $3.8M | 20.8K | 13 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 23.7K | $17.3M | $731.01 | 3.17x |
| 67028 | Injection of drug into eye | 12.5K | $1.2M | $93.89 | 6.87x |
| 92014 | Established patient complete exam of visual system | 10.6K | $943.4K | $89.16 | 2.75x |
| 92134 | Imaging of retina | 19.8K | $633.8K | $31.94 | 5.06x |
| J2778 | Injection, ranibizumab, 0.1 mg | 1.3K | $393.1K | $302.58 | 2.52x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 8.8K | $254.6K | $29.06 | 2.52x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 1.1K | $169.4K | $159.23 | 4.71x |
| 92004 | New patient complete exam of visual system | 1.3K | $139.7K | $108.10 | 2.65x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 1.1K | $108.1K | $100.88 | 1.88x |
| J9035 | Injection, bevacizumab, 10 mg | 1.6K | $92.4K | $56.63 | 2.94x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 991 | $86.1K | $86.84 | 3.44x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 176 | $85.0K | $482.80 | 5.15x |
| 99204 | New patient outpatient visit, total time 45-59 minutes | 341 | $42.4K | $124.30 | 2.21x |
| 92012 | Established patient problem focused exam of visual system | 672 | $39.9K | $59.37 | 3.11x |
| 92250 | Photography of the retina | 800 | $36.7K | $45.89 | 3.63x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 42 | $18.6K | $443.99 | 3.32x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 12 | $13.2K | $1.1K | 2.96x |
| 99213 | Established patient outpatient visit, total time 20-29 minutes | 174 | $10.9K | $62.57 | 2.68x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 411 | $9.7K | $23.58 | 3.37x |
| 76512 | 2d ultrasound scan of eye tissue and structures | 108 | $6.5K | $60.63 | 4.63x |
This provider submits charges 3.4 times higher than what Medicare actually pays.
A markup ratio of 3.4x means for every $100 Medicare pays, this provider initially charges $340. 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 IL for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Sohail Hasan, MD | Harvey, IL | $37.2M | ✓ Clear |
| Michael Mcclintock, M.D. | Chicago, IL | $34.3M | ✓ 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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