This provider averages 58 services per working day
Based on 146.0K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $25.3M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 58 services per working day raises questions about billing patterns.
68% of their billing comes from a single procedure code (J0178 — Injection, aflibercept, 1 mg).
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 | $389.59 | $175.73 | 2.22x | $213.86 | $2.3M | 12.8K | 20 |
| 2015 | $372.52 | $197.13 | 1.89x | $175.39 | $2.6M | 12.9K | 22 |
| 2016 | $371.65 | $199.08 | 1.87x | $172.57 | $2.7M | 13.7K | 25 |
| 2017 | $379.99 | $197.34 | 1.93x | $182.65 | $2.6M | 13.2K | 22 |
| 2018 | $391.48 | $202.22 | 1.94x | $189.26 | $2.7M | 13.4K | 21 |
| 2019 | $377.16 | $196.64 | 1.92x | $180.52 | $2.5M | 12.9K | 17 |
| 2020 | $414.14 | $218.97 | 1.89x | $195.17 | $1.9M | 8.8K | 17 |
| 2021 | $446.94 | $240.09 | 1.86x | $206.85 | $2.5M | 10.2K | 15 |
| 2022 | $358.01 | $192.02 | 1.86x | $165.99 | $2.6M | 13.5K | 14 |
| 2023 | $155.22 | $84.49 | 1.84x | $70.73 | $2.9M | 34.5K | 14 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 23.0K | $17.0M | $738.82 | 1.61x |
| 67028 | Injection of drug into eye | 16.9K | $1.4M | $81.79 | 3.37x |
| 92014 | Established patient complete exam of visual system | 15.6K | $1.3M | $84.53 | 2.29x |
| J2778 | Injection, ranibizumab, 0.1 mg | 3.7K | $1.1M | $306.34 | 1.57x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 11.5K | $945.2K | $82.46 | 2.20x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 27.7K | $803.9K | $29.05 | 1.38x |
| 92134 | Imaging of retina | 24.6K | $747.9K | $30.35 | 3.46x |
| 92250 | Photography of the retina | 6.4K | $287.5K | $45.19 | 3.76x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 2.1K | $246.2K | $118.37 | 2.32x |
| J3590 | Unclassified biologics | 3.4K | $245.7K | $72.43 | 3.03x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 234 | $216.5K | $925.27 | 3.41x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 2.8K | $168.0K | $60.14 | 2.19x |
| 92242 | Exam of retinal blood vessels and blood vessels between the white part of eye and retina using a special camera after injection of a dye | 669 | $118.9K | $177.77 | 3.33x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 269 | $100.9K | $375.12 | 3.81x |
| 92240 | Examination of eye using an endoscope | 351 | $96.4K | $274.61 | 2.35x |
| 92004 | New patient complete exam of visual system | 973 | $91.5K | $94.04 | 2.51x |
| 67145 | Preventive retinal detachment treatment by heat or laser, 1 or more sessions | 222 | $89.4K | $402.81 | 2.51x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 220 | $52.2K | $237.10 | 1.61x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 1.3K | $43.9K | $32.91 | 2.63x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 381 | $42.5K | $111.57 | 2.24x |
This provider submits charges 1.92 times higher than what Medicare actually pays.
A markup ratio of 1.92x means for every $100 Medicare pays, this provider initially charges $192. 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 MI for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Sandeep Randhawa, MD | Royal Oak, MI | $44.6M | ✓ Clear |
| Scott Sneed, MD | Traverse City, MI | $39.4M | ✓ Clear |
| Jeremy Wolfe, MD | Royal Oak, MI | $39.4M | ✓ Clear |
| Douglas Covert, MD, MPH | Traverse City, MI | $34.7M | ✓ 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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