This provider averages 77 services per working day
Based on 192.2K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $24.6M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 77 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 161% 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 | $482.65 | $181.56 | 2.66x | $301.09 | $1.5M | 8.0K | 19 |
| 2015 | $484.28 | $182.73 | 2.65x | $301.55 | $1.5M | 8.0K | 18 |
| 2016 | $504.86 | $183.51 | 2.75x | $321.35 | $1.6M | 8.6K | 20 |
| 2017 | $518.03 | $192.33 | 2.69x | $325.70 | $1.8M | 9.4K | 19 |
| 2018 | $494.80 | $186.32 | 2.66x | $308.48 | $2.1M | 11.5K | 19 |
| 2019 | $500.99 | $191.90 | 2.61x | $309.09 | $2.6M | 13.5K | 15 |
| 2020 | $547.22 | $212.20 | 2.58x | $335.02 | $2.7M | 12.7K | 12 |
| 2021 | $538.40 | $208.51 | 2.58x | $329.89 | $3.4M | 16.1K | 18 |
| 2022 | $356.59 | $137.29 | 2.60x | $219.30 | $3.7M | 27.3K | 15 |
| 2023 | $115.20 | $49.38 | 2.33x | $65.82 | $3.8M | 77.0K | 13 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 19.9K | $14.7M | $738.05 | 1.63x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 74.8K | $2.2M | $29.20 | 1.56x |
| 67028 | Injection of drug into eye | 24.6K | $2.0M | $81.15 | 10.67x |
| J2778 | Injection, ranibizumab, 0.1 mg | 6.7K | $1.8M | $272.94 | 1.77x |
| J3590 | Unclassified biologics | 13.9K | $968.2K | $69.78 | 1.80x |
| 92134 | Imaging of retina | 25.8K | $743.8K | $28.87 | 4.68x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 7.9K | $441.1K | $55.62 | 3.23x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 2.8K | $318.3K | $113.53 | 2.32x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 4.1K | $313.3K | $75.82 | 2.31x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 4.6K | $284.8K | $61.95 | 2.16x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 660 | $166.1K | $251.66 | 1.59x |
| 67041 | Removal of membrane of retina | 188 | $160.6K | $854.07 | 4.80x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 1.8K | $148.8K | $80.90 | 2.98x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina, with removal of vitreous fluid | 105 | $100.2K | $954.58 | 4.61x |
| 67042 | Removal of membrane from the retina, pars plana approach with removal of internal limiting membrane of retina | 80 | $70.9K | $886.66 | 4.62x |
| 92250 | Photography of the retina | 1.3K | $49.9K | $39.18 | 4.01x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 487 | $35.6K | $73.13 | 3.42x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 60 | $35.5K | $591.67 | 5.92x |
| J7999 | Compounded drug, not otherwise classified | 826 | $33.7K | $40.79 | 2.16x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 232 | $33.6K | $145.02 | 2.21x |
This provider submits charges 2.58 times higher than what Medicare actually pays.
A markup ratio of 2.58x means for every $100 Medicare pays, this provider initially charges $258. 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 IA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Kyle Alliman, M.D. | West Des Moines, IA | $83.3M | ✓ Clear |
| David Saggau, MD | West Des Moines, IA | $73.8M | ✓ Clear |
| Jared Nielsen, M.D., M.S. | West Des Moines, IA | $68.1M | ✓ Clear |
| Alex Kartvelishvili, M.D. | Iowa City, IA | $45.0M | ✓ Clear |
| Michael Wadzinski, M.D. | Sioux City, IA | $37.7M | ✓ 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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