This provider's $11.8M 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 | $326.96 | $247.38 | 1.32x | $79.58 | $886.6K | 10.0K | 4.8K |
| 2015 | $702.83 | $209.37 | 3.36x | $493.46 | $955.9K | 5.7K | 4.2K |
| 2016 | $427.24 | $164.85 | 2.59x | $262.39 | $1.2M | 7.4K | 3.9K |
| 2017 | $450.43 | $176.21 | 2.56x | $274.22 | $1.3M | 7.7K | 3.8K |
| 2018 | $247.22 | $104.81 | 2.36x | $142.41 | $1.1M | 6.9K | 3.5K |
| 2019 | $313.21 | $132.48 | 2.36x | $180.73 | $1.1M | 7.1K | 3.6K |
| 2020 | $473.33 | $196.43 | 2.41x | $276.90 | $1.4M | 7.4K | 3.9K |
| 2021 | $530.61 | $218.72 | 2.43x | $311.89 | $1.5M | 7.8K | 3.7K |
| 2022 | $490.29 | $198.04 | 2.48x | $292.25 | $1.3M | 7.4K | 3.3K |
| 2023 | $378.38 | $157.98 | 2.40x | $220.40 | $990.3K | 6.1K | 2.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 8.9K | $6.6M | $740.30 | 1.69x |
| J2778 | Injection, ranibizumab, 0.1 mg | 6.0K | $1.6M | $265.07 | 1.91x |
| 67028 | Injection of drug into eye | 18.4K | $1.6M | $84.67 | 3.35x |
| 92134 | Diagnostic imaging of retina | 18.6K | $531.2K | $28.59 | 2.68x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.7K | $301.5K | $53.26 | 2.68x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.6K | $181.6K | $113.94 | 2.42x |
| J3590 | Unclassified biologics | 2.9K | $146.6K | $50.72 | 2.98x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.8K | $143.0K | $77.64 | 2.46x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 1.7K | $137.5K | $82.80 | 2.45x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 1.6K | $91.7K | $56.13 | 2.40x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 1.1K | $85.2K | $74.97 | 2.33x |
| 67042 | Removal of membrane from the retina, pars plana approach | 78 | $70.6K | $905.26 | 2.71x |
| 92250 | Photography of the retina | 1.8K | $69.9K | $39.44 | 2.32x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 75 | $67.5K | $899.49 | 3.26x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 535 | $40.1K | $75.00 | 2.76x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 53 | $34.7K | $655.27 | 2.34x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 68 | $24.3K | $357.62 | 3.37x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 225 | $23.9K | $106.25 | 2.04x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 14 | $19.5K | $1.4K | 1.30x |
| 67145 | Preventive retinal detachment treatment by heat or laser, 1 or more sessions | 52 | $16.3K | $313.89 | 2.78x |
This provider submits charges 2.1 times higher than what Medicare actually pays.
A markup ratio of 2.1x means for every $100 Medicare pays, this provider initially charges $210. 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 KY for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Inder Singal, MD | Louisville, KY | $35.2M | ✓ 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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