This provider's $10.8M in total Medicare payments ranks in the 98th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 75% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 58% in 2016
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 | $483.92 | $209.02 | 2.32x | $274.90 | $590.5K | 6.9K | 2.2K |
| 2015 | $342.74 | $144.15 | 2.38x | $198.59 | $528.3K | 5.5K | 2.6K |
| 2016 | $779.30 | $255.96 | 3.04x | $523.34 | $833.9K | 6.8K | 2.8K |
| 2017 | $617.91 | $202.09 | 3.06x | $415.82 | $1.0M | 8.5K | 3.4K |
| 2018 | $632.78 | $221.14 | 2.86x | $411.64 | $1.1M | 9.6K | 3.5K |
| 2019 | $613.13 | $212.64 | 2.88x | $400.49 | $1.5M | 10.5K | 4.0K |
| 2020 | $720.73 | $209.17 | 3.45x | $511.56 | $1.2M | 9.4K | 3.3K |
| 2021 | $744.65 | $226.68 | 3.29x | $517.97 | $1.5M | 10.2K | 3.4K |
| 2022 | $616.45 | $182.03 | 3.39x | $434.42 | $1.4M | 9.7K | 3.5K |
| 2023 | $739.33 | $244.40 | 3.03x | $494.93 | $1.0M | 9.4K | 3.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 6.6K | $4.9M | $736.37 | 1.69x |
| 67028 | Injection of drug into eye | 17.7K | $1.3M | $75.36 | 4.09x |
| J2778 | Injection, ranibizumab, 0.1 mg | 2.8K | $771.1K | $275.68 | 1.82x |
| 92134 | Diagnostic imaging of retina | 27.2K | $768.5K | $28.24 | 3.67x |
| J3590 | Unclassified biologics | 5.7K | $565.7K | $98.83 | 2.32x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 7.9K | $425.9K | $53.80 | 2.74x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.8K | $373.0K | $78.03 | 2.71x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 4.2K | $344.3K | $81.27 | 2.72x |
| 66984 | Removal of cataract with insertion of lens | 545 | $236.9K | $434.71 | 3.17x |
| 67042 | Removal of membrane from the retina, pars plana approach | 190 | $166.9K | $878.48 | 3.24x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 565 | $140.8K | $249.25 | 1.84x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 1.7K | $96.4K | $57.03 | 2.60x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 105 | $88.4K | $841.96 | 3.60x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 359 | $84.8K | $236.20 | 3.33x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 690 | $77.2K | $111.88 | 2.72x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 175 | $64.3K | $367.64 | 3.16x |
| J3490 | Unclassified drugs | 26 | $44.6K | $1.7K | 1.75x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 478 | $36.9K | $77.27 | 3.21x |
| 67145 | Preventive retinal detachment treatment by heat or laser, 1 or more sessions | 95 | $31.5K | $331.39 | 3.32x |
| 92083 | Measurement of field of vision during daylight conditions | 665 | $26.8K | $40.36 | 4.06x |
This provider submits charges 2.45 times higher than what Medicare actually pays.
A markup ratio of 2.45x means for every $100 Medicare pays, this provider initially charges $245. 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 NE for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| John Welch, MD | Hastings, NE | $94.8M | ✓ Clear |
| William Terrell, M.D. | Hastings, NE | $59.3M | ✓ 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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