This provider averages 52 services per working day
Based on 130.5K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $20.7M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 52 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 937% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 423% in 2017
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 | $236.96 | $66.89 | 3.54x | $170.07 | $301.8K | 4.5K | 19 |
| 2015 | $247.34 | $64.06 | 3.86x | $183.28 | $251.8K | 3.9K | 19 |
| 2016 | $255.64 | $63.68 | 4.01x | $191.96 | $227.4K | 3.6K | 18 |
| 2017 | $321.28 | $158.04 | 2.03x | $163.24 | $1.2M | 7.5K | 22 |
| 2018 | $356.96 | $214.21 | 1.67x | $142.75 | $3.7M | 17.5K | 24 |
| 2019 | $356.40 | $202.92 | 1.76x | $153.48 | $3.5M | 17.4K | 27 |
| 2020 | $382.21 | $206.74 | 1.85x | $175.47 | $3.0M | 14.6K | 26 |
| 2021 | $378.76 | $186.47 | 2.03x | $192.29 | $2.8M | 15.1K | 27 |
| 2022 | $414.58 | $171.93 | 2.41x | $242.65 | $2.5M | 14.5K | 24 |
| 2023 | $216.33 | $98.20 | 2.20x | $118.13 | $3.1M | 31.9K | 28 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 16.2K | $11.9M | $731.24 | 1.36x |
| J2778 | Injection, ranibizumab, 0.1 mg | 8.4K | $2.2M | $265.99 | 1.97x |
| 67028 | Injection of drug into eye | 17.0K | $1.5M | $88.47 | 6.00x |
| 92134 | Imaging of retina | 19.3K | $585.9K | $30.33 | 2.65x |
| 92014 | Established patient complete exam of visual system | 6.2K | $536.4K | $85.98 | 1.84x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 18.1K | $520.5K | $28.82 | 1.45x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 3.1K | $485.0K | $154.33 | 1.37x |
| J9035 | Injection, bevacizumab, 10 mg | 7.9K | $430.6K | $54.44 | 1.38x |
| 92250 | Photography of the retina | 7.7K | $211.6K | $27.44 | 3.67x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 218 | $192.9K | $884.85 | 2.60x |
| 67040 | Destruction of eye fluid (vitreous) between lens and retina and all of retina using a laser | 245 | $192.5K | $785.60 | 3.85x |
| 66984 | Removal of cataract with insertion of prosthetic lens | 463 | $182.3K | $393.66 | 3.97x |
| 67210 | Destruction of growth of retina using a laser | 417 | $175.3K | $420.30 | 3.30x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 9.8K | $171.6K | $17.42 | 4.63x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 1.9K | $141.2K | $73.28 | 2.94x |
| 92012 | Established patient problem focused exam of visual system | 2.3K | $140.0K | $60.32 | 1.64x |
| Q5124 | Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg | 680 | $116.2K | $170.82 | 2.37x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 176 | $114.0K | $647.73 | 4.16x |
| 67113 | Complex repair of detached retina and drainage of eye fluid between lens and retina | 103 | $110.4K | $1.1K | 2.78x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1.8K | $107.4K | $59.17 | 2.18x |
This provider submits charges 2.03 times higher than what Medicare actually pays.
A markup ratio of 2.03x means for every $100 Medicare pays, this provider initially charges $203. 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 MO for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Stephen Wiles, MD | Kansas City, MO | $44.4M | ✓ Clear |
| Mari Keithahn, M.D. | Columbia, MO | $44.2M | ✓ 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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