This provider's $7.8M in total Medicare payments ranks in the 98th percentile of Ophthalmology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $904.22 | $209.47 | 4.32x | $694.75 | $631.5K | 9.6K | 3.1K |
| 2015 | $995.76 | $225.38 | 4.42x | $770.38 | $654.6K | 9.8K | 3.1K |
| 2016 | $1.3K | $230.67 | 5.80x | $1.1K | $709.8K | 10.6K | 3.5K |
| 2017 | $571.29 | $134.30 | 4.25x | $436.99 | $619.9K | 10.8K | 3.4K |
| 2018 | $1.1K | $186.17 | 5.70x | $875.02 | $701.2K | 11.1K | 3.4K |
| 2019 | $1.1K | $205.48 | 5.51x | $927.01 | $861.9K | 11.4K | 3.5K |
| 2020 | $1.2K | $226.77 | 5.12x | $933.55 | $811.2K | 10.2K | 2.9K |
| 2021 | $1.8K | $260.08 | 6.87x | $1.5K | $1.0M | 12.8K | 3.9K |
| 2022 | $647.25 | $152.68 | 4.24x | $494.57 | $908.9K | 11.4K | 3.1K |
| 2023 | $1.3K | $208.46 | 6.14x | $1.1K | $875.7K | 11.2K | 3.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 23.0K | $1.9M | $84.76 | 2.22x |
| J0178 | Injection, aflibercept, 1 mg | 2.1K | $1.5M | $732.02 | 2.66x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 13.0K | $986.4K | $76.12 | 3.37x |
| 67028 | Injection of drug into eye | 11.1K | $874.7K | $78.59 | 9.29x |
| 92134 | Diagnostic imaging of retina | 15.9K | $464.9K | $29.30 | 2.89x |
| 92250 | Photography of the retina | 8.0K | $340.5K | $42.82 | 2.98x |
| J9035 | Injection, bevacizumab, 10 mg | 5.0K | $291.7K | $58.73 | 1.94x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 603 | $227.5K | $377.35 | 6.50x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 12.9K | $222.4K | $17.29 | 11.23x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.9K | $213.9K | $114.12 | 1.93x |
| 92201 | Extended examination of eye with drawing of retina | 10.1K | $179.3K | $17.82 | 10.88x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 284 | $103.3K | $363.60 | 4.90x |
| J3590 | Unclassified biologics | 2.5K | $98.2K | $39.10 | 2.91x |
| 67042 | Removal of membrane from the retina, pars plana approach | 103 | $95.7K | $928.85 | 6.35x |
| J2778 | Injection, ranibizumab, 0.1 mg | 279 | $85.8K | $307.43 | 2.54x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 36 | $32.6K | $904.46 | 8.60x |
| 67220 | Destruction of vascular growth between retina and sclera, 1 or more sessions | 62 | $24.8K | $399.42 | 6.66x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 1.1K | $21.7K | $19.49 | 11.19x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 519 | $15.1K | $29.09 | 2.61x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina, complex | 12 | $12.0K | $1.0K | 8.10x |
This provider submits charges 4.08 times higher than what Medicare actually pays.
A markup ratio of 4.08x means for every $100 Medicare pays, this provider initially charges $408. 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 IN for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Drew Sommerville, MD | Evansville, IN | $35.4M | ✓ 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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