This provider averages 60 services per working day
Based on 149.1K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $23.1M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 60 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 2932% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 832% in 2018
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 | $271.49 | $79.78 | 3.40x | $191.71 | $140.6K | 1.8K | 13 |
| 2015 | $231.94 | $51.64 | 4.49x | $180.30 | $103.1K | 2.0K | 13 |
| 2016 | $234.93 | $51.55 | 4.56x | $183.38 | $148.7K | 2.9K | 13 |
| 2017 | $299.03 | $89.47 | 3.34x | $209.56 | $261.5K | 2.9K | 16 |
| 2018 | $318.25 | $238.64 | 1.33x | $79.61 | $2.4M | 10.2K | 17 |
| 2019 | $321.05 | $232.29 | 1.38x | $88.76 | $3.8M | 16.5K | 18 |
| 2020 | $348.41 | $250.72 | 1.39x | $97.69 | $3.8M | 15.3K | 17 |
| 2021 | $348.67 | $247.68 | 1.41x | $100.99 | $4.0M | 16.1K | 19 |
| 2022 | $282.15 | $195.32 | 1.44x | $86.83 | $4.1M | 20.9K | 16 |
| 2023 | $104.37 | $70.53 | 1.48x | $33.84 | $4.3M | 60.4K | 17 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 15.7K | $11.4M | $728.99 | 1.37x |
| J2778 | Injection, ranibizumab, 0.1 mg | 22.4K | $5.7M | $256.22 | 1.58x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 52.0K | $1.5M | $29.14 | 1.33x |
| 67028 | Injection of drug into eye | 13.8K | $1.2M | $88.09 | 1.89x |
| 92014 | Established patient complete exam of visual system | 11.0K | $992.8K | $89.87 | 1.43x |
| 92134 | Imaging of retina | 22.5K | $641.6K | $28.54 | 1.71x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 1.7K | $269.4K | $157.06 | 1.31x |
| J3590 | Unclassified biologics | 868 | $197.6K | $227.62 | 1.46x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 1.9K | $151.4K | $78.79 | 1.48x |
| 67041 | Removal of membrane of retina | 161 | $146.9K | $912.11 | 1.27x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 150 | $133.3K | $888.67 | 2.19x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 153 | $102.5K | $670.04 | 1.87x |
| 92004 | New patient complete exam of visual system | 878 | $93.4K | $106.36 | 1.44x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 2.3K | $88.0K | $37.98 | 3.33x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 82 | $75.1K | $916.26 | 1.32x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 174 | $54.4K | $312.69 | 1.90x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 452 | $49.9K | $110.47 | 1.88x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 501 | $43.1K | $86.02 | 1.63x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 121 | $42.5K | $350.96 | 1.52x |
| 92012 | Established patient problem focused exam of visual system | 552 | $36.7K | $66.49 | 1.34x |
This provider submits charges 1.48 times higher than what Medicare actually pays.
A markup ratio of 1.48x means for every $100 Medicare pays, this provider initially charges $148. 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 NC for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Shil Patel, M.D. | New Bern, NC | $63.1M | ✓ Clear |
| James Pate, M.D. | Raleigh, NC | $44.5M | ✓ Clear |
| Justin Brown, M.D. | Charlotte, NC | $43.5M | ✓ Clear |
| Nitin Gupta, M.D., M.P.H. | Raleigh, NC | $42.0M | ✓ Clear |
| Igor Westra, MD | Wilmington, NC | $40.5M | ✓ 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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