This provider averages 57 services per working day
Based on 141.8K total services over 10 years (250 working days/year). Learn about impossible service volumes โ
This provider's $12.2M in total Medicare payments ranks in the 98th percentile of Ophthalmology providers nationally.
Averaging 57 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 1759% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 287% 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 โ the gap represents the markup.
| Year | Avg Submitted | Avg Paid | Markup Ratio | Gap per Service | Total Payments | Services | Beneficiaries |
|---|---|---|---|---|---|---|---|
| 2014 | $331.41 | $85.47 | 3.88x | $245.94 | $184.7K | 2.2K | 15 |
| 2015 | $337.68 | $86.11 | 3.92x | $251.57 | $110.2K | 1.3K | 12 |
| 2016 | $292.56 | $74.03 | 3.95x | $218.53 | $61.6K | 832 | 11 |
| 2017 | $329.53 | $61.71 | 5.34x | $267.82 | $172.4K | 2.8K | 14 |
| 2018 | $302.32 | $76.91 | 3.93x | $225.41 | $667.4K | 8.7K | 20 |
| 2019 | $353.41 | $116.93 | 3.02x | $236.48 | $1.4M | 11.6K | 22 |
| 2020 | $408.17 | $150.73 | 2.71x | $257.44 | $1.9M | 12.7K | 24 |
| 2021 | $411.37 | $155.74 | 2.64x | $255.63 | $2.0M | 12.9K | 22 |
| 2022 | $428.55 | $145.95 | 2.94x | $282.60 | $2.3M | 15.5K | 21 |
| 2023 | $133.91 | $46.88 | 2.86x | $87.03 | $3.4M | 73.3K | 28 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 7.6K | $5.5M | $724.24 | 2.34x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 61.4K | $1.8M | $28.90 | 2.56x |
| 92014 | Established patient complete exam of visual system | 12.0K | $1.0M | $85.90 | 3.62x |
| 67028 | Injection of drug into eye | 11.5K | $910.7K | $79.50 | 3.70x |
| 92134 | Imaging of retina | 18.3K | $519.7K | $28.40 | 3.62x |
| J3590 | Unclassified biologics | 6.1K | $373.9K | $61.08 | 3.34x |
| 92242 | Exam of retinal blood vessels and blood vessels between the white part of eye and retina using a special camera after injection of a dye | 1.6K | $294.4K | $178.51 | 3.25x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 3.4K | $260.0K | $76.13 | 3.71x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 950 | $246.9K | $259.88 | 5.94x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.8K | $198.0K | $111.31 | 3.87x |
| 67210 | Destruction of growth of retina using a laser | 459 | $176.4K | $384.29 | 3.91x |
| 92250 | Photography of the retina | 4.7K | $154.6K | $33.10 | 4.56x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 1.6K | $135.4K | $82.68 | 3.63x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 293 | $86.3K | $294.52 | 4.28x |
| 92004 | New patient complete exam of visual system | 778 | $78.3K | $100.58 | 3.85x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 2.4K | $48.9K | $20.83 | 3.86x |
| 76512 | 2d ultrasound scan of eye tissue and structures | 1.0K | $46.9K | $45.33 | 4.10x |
| 92012 | Established patient problem focused exam of visual system | 728 | $44.1K | $60.60 | 3.71x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 360 | $43.3K | $120.36 | 2.58x |
| J2778 | Injection, ranibizumab, 0.1 mg | 155 | $40.5K | $261.30 | 2.26x |
This provider submits charges 2.96 times higher than what Medicare actually pays.
A markup ratio of 2.96x means for every $100 Medicare pays, this provider initially charges $296. 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 | โ 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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