This provider's $4.8M in total Medicare payments ranks in the 96th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 127% 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 | $352.80 | $127.45 | 2.77x | $225.35 | $269.2K | 2.2K | 1.6K |
| 2015 | $434.34 | $144.08 | 3.01x | $290.26 | $286.5K | 2.3K | 1.7K |
| 2016 | $429.22 | $153.00 | 2.81x | $276.22 | $387.3K | 3.0K | 1.9K |
| 2017 | $453.61 | $146.72 | 3.09x | $306.89 | $486.7K | 3.7K | 2.3K |
| 2018 | $585.34 | $175.22 | 3.34x | $410.12 | $477.0K | 3.6K | 2.2K |
| 2019 | $689.32 | $175.38 | 3.93x | $513.94 | $535.0K | 3.9K | 2.3K |
| 2020 | $565.56 | $173.16 | 3.27x | $392.40 | $491.6K | 3.5K | 2.3K |
| 2021 | $520.50 | $156.28 | 3.33x | $364.22 | $577.3K | 4.1K | 2.6K |
| 2022 | $565.72 | $168.91 | 3.35x | $396.81 | $670.3K | 4.4K | 2.7K |
| 2023 | $510.15 | $147.12 | 3.47x | $363.03 | $610.1K | 4.5K | 2.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 2.9K | $2.1M | $729.83 | 2.04x |
| 66984 | Removal of cataract with insertion of lens | 1.6K | $708.3K | $434.83 | 4.29x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 5.8K | $479.6K | $83.32 | 3.32x |
| 67028 | Injection of drug into eye | 3.2K | $273.2K | $84.87 | 4.32x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 4.6K | $239.9K | $52.23 | 3.09x |
| 92134 | Diagnostic imaging of retina | 6.9K | $204.3K | $29.41 | 3.60x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 2.2K | $135.0K | $61.20 | 3.04x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 280 | $79.8K | $285.04 | 3.50x |
| 65820 | Incision to improve eye fluid flow | 110 | $70.5K | $641.33 | 2.89x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 587 | $57.2K | $97.50 | 3.34x |
| 92136 | Measurement of corneal curvature and depth of eye | 1.6K | $57.2K | $36.06 | 3.57x |
| 92083 | Measurement of field of vision during daylight conditions | 1.4K | $56.8K | $40.87 | 3.63x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 553 | $40.8K | $73.77 | 3.11x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 407 | $38.1K | $93.59 | 3.20x |
| 66982 | Removal of cataract with insertion of lens | 63 | $37.3K | $592.14 | 3.48x |
| 68761 | Closure of tear duct opening using plug | 236 | $33.3K | $141.15 | 3.31x |
| 92133 | Diagnostic imaging of optic nerve of eye | 1.2K | $30.5K | $25.29 | 4.09x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 112 | $24.8K | $221.02 | 5.45x |
| 66174 | Dilation to improve eye fluid flow | 30 | $22.7K | $755.54 | 2.83x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 119 | $14.0K | $117.89 | 3.00x |
This provider submits charges 2.97 times higher than what Medicare actually pays.
A markup ratio of 2.97x means for every $100 Medicare pays, this provider initially charges $297. 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 ND for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Max Johnson, MD | Fargo, ND | $37.3M | ✓ 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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