This provider's $6.6M in total Medicare payments ranks in the 97th 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 | $494.60 | $170.54 | 2.90x | $324.06 | $703.0K | 5.7K | 4.1K |
| 2015 | $446.27 | $148.02 | 3.01x | $298.25 | $733.8K | 6.0K | 4.3K |
| 2016 | $355.40 | $118.28 | 3.00x | $237.12 | $688.2K | 5.5K | 3.9K |
| 2017 | $455.81 | $144.14 | 3.16x | $311.67 | $713.5K | 6.0K | 4.2K |
| 2018 | $444.38 | $140.55 | 3.16x | $303.83 | $753.9K | 6.1K | 4.2K |
| 2019 | $380.14 | $123.22 | 3.09x | $256.92 | $627.3K | 5.4K | 3.7K |
| 2020 | $563.26 | $206.77 | 2.72x | $356.49 | $579.3K | 4.4K | 3.2K |
| 2021 | $397.60 | $121.39 | 3.28x | $276.21 | $682.5K | 5.2K | 3.5K |
| 2022 | $557.22 | $207.76 | 2.68x | $349.46 | $651.0K | 4.7K | 3.2K |
| 2023 | $405.08 | $121.26 | 3.34x | $283.82 | $417.6K | 4.1K | 2.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 3.0K | $2.3M | $747.98 | 1.96x |
| 66984 | Removal of cataract with insertion of lens | 3.1K | $1.3M | $417.97 | 4.19x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 11.5K | $955.1K | $82.96 | 3.24x |
| 92134 | Diagnostic imaging of retina | 11.8K | $355.0K | $29.97 | 3.56x |
| 67028 | Injection of drug into eye | 3.5K | $286.9K | $81.47 | 4.34x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 4.9K | $258.8K | $53.09 | 3.00x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 899 | $245.5K | $273.09 | 3.41x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 3.4K | $208.7K | $61.59 | 2.99x |
| 92136 | Measurement of corneal curvature and depth of eye | 2.8K | $116.0K | $40.84 | 3.25x |
| 92083 | Measurement of field of vision during daylight conditions | 2.4K | $101.4K | $42.83 | 3.50x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 950 | $94.0K | $98.94 | 3.28x |
| J3590 | Unclassified biologics | 48 | $76.3K | $1.6K | 1.95x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 959 | $69.1K | $72.08 | 3.07x |
| 66982 | Removal of cataract with insertion of lens | 77 | $45.5K | $591.37 | 3.48x |
| 92133 | Diagnostic imaging of optic nerve of eye | 1.6K | $43.5K | $27.06 | 3.92x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 464 | $43.2K | $93.00 | 3.16x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 353 | $39.0K | $110.52 | 3.16x |
| 92025 | Computerized mapping of corneal curvature | 499 | $13.9K | $27.83 | 2.85x |
| 92002 | Eye and medical examination for diagnosis and treatment, new patient | 186 | $9.7K | $52.34 | 3.34x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 13 | $8.3K | $637.42 | 2.76x |
This provider submits charges 3.03 times higher than what Medicare actually pays.
A markup ratio of 3.03x means for every $100 Medicare pays, this provider initially charges $303. 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 ND for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Max Johnson, MD | Fargo, ND | $37.3M | ✓ 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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