This provider averages 56 services per working day
Based on 139.1K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $16.0M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 56 services per working day raises questions about billing patterns.
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 | $1.7K | $374.82 | 4.48x | $1.3K | $1.7M | 11.6K | 2.3K |
| 2015 | $1.3K | $294.52 | 4.36x | $990.39 | $1.7M | 11.3K | 2.2K |
| 2016 | $1.0K | $275.81 | 3.74x | $755.31 | $1.3M | 10.0K | 1.9K |
| 2017 | $968.20 | $242.42 | 3.99x | $725.78 | $1.7M | 14.2K | 3.2K |
| 2018 | $891.47 | $199.71 | 4.46x | $691.76 | $1.8M | 16.1K | 3.1K |
| 2019 | $710.85 | $202.06 | 3.52x | $508.79 | $1.7M | 15.2K | 3.6K |
| 2020 | $689.33 | $174.22 | 3.96x | $515.11 | $1.9M | 18.1K | 3.9K |
| 2021 | $597.98 | $158.92 | 3.76x | $439.06 | $1.8M | 16.2K | 3.6K |
| 2022 | $527.46 | $151.19 | 3.49x | $376.27 | $1.5M | 14.5K | 3.1K |
| 2023 | $458.78 | $148.00 | 3.10x | $310.78 | $912.0K | 12.0K | 2.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 11.8K | $8.9M | $750.34 | 1.53x |
| 67028 | Injection of drug into eye | 37.1K | $2.8M | $74.49 | 8.73x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 21.7K | $1.3M | $60.27 | 1.69x |
| 92134 | Diagnostic imaging of retina | 37.2K | $1.1M | $29.88 | 2.34x |
| J3590 | Unclassified biologics | 16.3K | $641.7K | $39.25 | 2.04x |
| J9035 | Injection, bevacizumab, 10 mg | 6.6K | $358.3K | $54.14 | 1.85x |
| 67041 | Removal of membrane from the retina | 233 | $205.8K | $883.40 | 4.55x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.1K | $163.8K | $53.18 | 1.92x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 238 | $89.3K | $375.01 | 6.01x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 356 | $88.9K | $249.68 | 1.40x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 566 | $57.1K | $100.83 | 1.56x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 714 | $55.0K | $77.08 | 2.18x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 580 | $43.2K | $74.49 | 3.78x |
| 67040 | Laser destruction of eye fluid (vitreous) between the lens and retina | 45 | $41.6K | $924.55 | 5.96x |
| 67042 | Removal of membrane from the retina, pars plana approach | 44 | $37.7K | $855.74 | 5.97x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 42 | $28.2K | $671.68 | 1.72x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 893 | $26.0K | $29.14 | 1.44x |
| 00145 | Anesthesia for retinal surgery | 178 | $24.8K | $139.24 | 5.36x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 18 | $21.5K | $1.2K | 6.05x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 73 | $18.4K | $252.59 | 9.86x |
This provider submits charges 2.99 times higher than what Medicare actually pays.
A markup ratio of 2.99x means for every $100 Medicare pays, this provider initially charges $299. 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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