This provider averages 76 services per working day
Based on 189.7K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $24.1M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 76 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 102% 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 | $329.99 | $105.95 | 3.11x | $224.04 | $1.6M | 15.0K | 16 |
| 2015 | $338.24 | $95.77 | 3.53x | $242.47 | $1.5M | 15.7K | 21 |
| 2016 | $387.86 | $124.14 | 3.12x | $263.72 | $2.1M | 17.3K | 15 |
| 2017 | $410.54 | $135.58 | 3.03x | $274.96 | $2.4M | 17.9K | 17 |
| 2018 | $398.46 | $134.47 | 2.96x | $263.99 | $2.5M | 18.8K | 16 |
| 2019 | $410.66 | $143.37 | 2.86x | $267.29 | $2.9M | 19.9K | 18 |
| 2020 | $413.43 | $143.39 | 2.88x | $270.04 | $2.7M | 18.7K | 16 |
| 2021 | $409.85 | $138.09 | 2.97x | $271.76 | $2.6M | 18.7K | 17 |
| 2022 | $443.23 | $139.94 | 3.17x | $303.29 | $2.6M | 18.6K | 18 |
| 2023 | $318.96 | $110.73 | 2.88x | $208.23 | $3.2M | 29.0K | 18 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 12.0K | $8.9M | $741.26 | 1.72x |
| J2778 | Injection, ranibizumab, 0.1 mg | 20.4K | $5.2M | $256.95 | 1.93x |
| 67028 | Injection of drug into eye | 35.2K | $2.9M | $83.17 | 8.94x |
| J9035 | Injection, bevacizumab, 10 mg | 34.3K | $1.9M | $55.64 | 1.58x |
| 92134 | Imaging of retina | 43.3K | $1.3M | $30.16 | 4.97x |
| 92014 | Established patient complete exam of visual system | 14.6K | $1.2M | $83.52 | 2.98x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 3.0K | $635.9K | $214.24 | 1.85x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 10.1K | $294.2K | $29.01 | 1.90x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 2.5K | $284.8K | $112.48 | 2.55x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 3.5K | $270.4K | $77.57 | 4.68x |
| 67210 | Destruction of growth of retina using a laser | 560 | $213.2K | $380.80 | 3.94x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 460 | $181.5K | $394.62 | 5.00x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 194 | $173.3K | $893.32 | 4.32x |
| 92012 | Established patient problem focused exam of visual system | 3.0K | $166.3K | $55.24 | 2.59x |
| 92250 | Photography of the retina | 3.2K | $117.2K | $36.72 | 3.97x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 255 | $90.4K | $354.51 | 4.58x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 994 | $75.7K | $76.18 | 2.63x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1.0K | $60.6K | $60.52 | 2.31x |
| 92004 | New patient complete exam of visual system | 279 | $27.2K | $97.52 | 3.08x |
| 99205 | New patient outpatient visit, total time 60-74 minutes | 117 | $16.6K | $142.15 | 2.81x |
This provider submits charges 3.02 times higher than what Medicare actually pays.
A markup ratio of 3.02x means for every $100 Medicare pays, this provider initially charges $302. 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 TN for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Roy Wallace, MD | Nashville, TN | $48.8M | ✓ Clear |
| Carl Awh, M.D. | Nashville, TN | $48.0M | ✓ Clear |
| David Reichstein, M.D | Nashville, TN | $40.5M | ✓ Clear |
| Brandon Busbee, M.D. | Nashville, TN | $40.2M | ✓ Clear |
| Franco Recchia, MD | Nashville, TN | $39.8M | ✓ 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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