This provider averages 114 services per working day
Based on 284.6K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $25.5M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 114 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 77% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 67% in 2019
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 | $221.15 | $70.37 | 3.14x | $150.78 | $1.9M | 26.8K | 25 |
| 2015 | $230.10 | $72.08 | 3.19x | $158.02 | $1.8M | 25.3K | 24 |
| 2016 | $239.40 | $73.29 | 3.27x | $166.11 | $1.8M | 24.1K | 21 |
| 2017 | $246.41 | $72.44 | 3.40x | $173.97 | $1.7M | 23.4K | 22 |
| 2018 | $258.62 | $78.05 | 3.31x | $180.57 | $1.9M | 24.9K | 22 |
| 2019 | $294.35 | $98.82 | 2.98x | $195.53 | $3.2M | 32.9K | 25 |
| 2020 | $343.22 | $118.36 | 2.90x | $224.86 | $3.6M | 30.6K | 25 |
| 2021 | $337.58 | $112.94 | 2.99x | $224.64 | $3.2M | 28.3K | 26 |
| 2022 | $325.51 | $108.38 | 3.00x | $217.13 | $3.0M | 27.4K | 22 |
| 2023 | $197.18 | $81.44 | 2.42x | $115.74 | $3.3M | 40.9K | 26 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 17.2K | $12.7M | $735.79 | 1.45x |
| 92012 | Established patient problem focused exam of visual system | 50.7K | $2.9M | $56.24 | 1.49x |
| 67028 | Injection of drug into eye | 26.1K | $2.2M | $82.78 | 14.84x |
| 92014 | Established patient complete exam of visual system | 17.7K | $1.4M | $77.12 | 1.55x |
| 92134 | Imaging of retina | 30.6K | $846.6K | $27.65 | 3.25x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 51.5K | $845.2K | $16.40 | 3.66x |
| J3590 | Unclassified biologics | 12.9K | $709.5K | $55.14 | 2.89x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 2.8K | $690.7K | $249.71 | 1.40x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 8.1K | $572.1K | $70.30 | 3.13x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 16.0K | $466.6K | $29.12 | 1.38x |
| J9035 | Injection, bevacizumab, 10 mg | 7.1K | $400.9K | $56.54 | 2.66x |
| 67041 | Removal of membrane of retina | 339 | $287.4K | $847.66 | 5.88x |
| 92250 | Photography of the retina | 6.7K | $262.8K | $38.96 | 2.32x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 2.4K | $250.4K | $105.07 | 1.75x |
| 92202 | Extended exam of the back part of the eye with optic nerve drawing | 22.6K | $240.1K | $10.63 | 6.12x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina, with removal of vitreous fluid | 100 | $97.1K | $970.79 | 5.21x |
| 66821 | Removal of recurring cataract in lens capsule using a laser | 357 | $83.8K | $234.87 | 2.56x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 89 | $78.1K | $877.15 | 5.70x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 3.7K | $71.3K | $19.25 | 3.12x |
| 92133 | Imaging of optic nerve | 2.7K | $70.5K | $26.00 | 3.46x |
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 MO for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Stephen Wiles, MD | Kansas City, MO | $44.4M | ✓ Clear |
| Mari Keithahn, M.D. | Columbia, MO | $44.2M | ✓ 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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