This provider's $4.7M in total Medicare payments ranks in the 96th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 90% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 70% in 2015
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 | $233.73 | $154.90 | 1.51x | $78.83 | $265.9K | 3.1K | 1.3K |
| 2015 | $202.42 | $124.61 | 1.62x | $77.81 | $452.4K | 4.5K | 1.7K |
| 2016 | $201.70 | $127.75 | 1.58x | $73.95 | $477.5K | 4.5K | 1.7K |
| 2017 | $236.72 | $144.57 | 1.64x | $92.15 | $467.8K | 3.9K | 1.6K |
| 2018 | $225.15 | $138.54 | 1.63x | $86.61 | $463.3K | 3.9K | 1.6K |
| 2019 | $197.47 | $132.27 | 1.49x | $65.20 | $521.3K | 4.1K | 1.7K |
| 2020 | $190.68 | $129.48 | 1.47x | $61.20 | $527.1K | 4.1K | 1.5K |
| 2021 | $184.33 | $125.30 | 1.47x | $59.03 | $543.3K | 4.2K | 1.6K |
| 2022 | $227.21 | $152.47 | 1.49x | $74.74 | $512.8K | 4.2K | 1.7K |
| 2023 | $222.97 | $148.54 | 1.50x | $74.43 | $505.1K | 3.9K | 1.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 2.5K | $1.8M | $733.37 | 1.64x |
| 67028 | Injection of drug into eye | 7.1K | $634.5K | $89.03 | 1.43x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 8.9K | $551.6K | $62.00 | 1.45x |
| 66984 | Removal of cataract with insertion of lens | 1.2K | $528.3K | $439.89 | 1.48x |
| 92134 | Diagnostic imaging of retina | 7.6K | $244.8K | $32.06 | 1.39x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 2.4K | $208.2K | $85.48 | 1.51x |
| J7999 | Compounded drug, not otherwise classified | 2.8K | $176.4K | $64.13 | 1.34x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 502 | $126.7K | $252.34 | 1.43x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 1.1K | $112.7K | $98.73 | 1.58x |
| J3590 | Unclassified biologics | 1.5K | $92.4K | $60.81 | 1.65x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.2K | $65.0K | $53.03 | 1.47x |
| 92136 | Measurement of corneal curvature and depth of eye | 1.1K | $42.2K | $39.63 | 1.43x |
| 92083 | Measurement of field of vision during daylight conditions | 647 | $30.0K | $46.41 | 1.42x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 136 | $26.9K | $198.04 | 1.38x |
| 92133 | Diagnostic imaging of optic nerve of eye | 774 | $20.9K | $26.99 | 1.53x |
| J2778 | Injection, ranibizumab, 0.1 mg | 55 | $17.1K | $311.11 | 1.30x |
| 66982 | Complex removal of cataract with insertion of prosthetic lens | 29 | $14.8K | $511.00 | 1.59x |
| J9035 | Injection, bevacizumab, 10 mg | 247 | $12.7K | $51.62 | 1.61x |
| 76519 | Ultrasound of eye for determination of lens power | 229 | $9.5K | $41.53 | 1.65x |
| Q9977 | Compounded Drug, Not Otherwise Classified | 110 | $6.0K | $54.57 | 1.37x |
This provider submits charges 1.53 times higher than what Medicare actually pays.
A markup ratio of 1.53x means for every $100 Medicare pays, this provider initially charges $153. This is lower 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 SD for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Prema Abraham, MD | Rapid City, SD | $39.1M | ✓ 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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