This provider's $23.8M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 262961% from 2014 to 2023.
68% of their billing comes from a single procedure code (J0178 — Injection, aflibercept, 1 mg).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 41696% in 2016
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 — the gap represents the markup.
| Year | Avg Submitted | Avg Paid | Markup Ratio | Gap per Service | Total Payments | Services | Beneficiaries |
|---|---|---|---|---|---|---|---|
| 2014 | $141.27 | $29.53 | 4.78x | $111.74 | $1.2K | 41 | 2 |
| 2015 | $144.09 | $25.96 | 5.55x | $118.13 | $2.2K | 86 | 2 |
| 2016 | $513.54 | $283.15 | 1.81x | $230.39 | $933.3K | 3.3K | 13 |
| 2017 | $528.36 | $288.17 | 1.83x | $240.19 | $2.7M | 9.3K | 23 |
| 2018 | $530.54 | $267.78 | 1.98x | $262.76 | $3.1M | 11.7K | 23 |
| 2019 | $500.40 | $266.52 | 1.88x | $233.88 | $3.6M | 13.5K | 24 |
| 2020 | $513.67 | $275.50 | 1.86x | $238.17 | $3.7M | 13.5K | 23 |
| 2021 | $562.66 | $295.67 | 1.90x | $266.99 | $3.5M | 11.9K | 21 |
| 2022 | $488.28 | $251.73 | 1.94x | $236.55 | $3.1M | 12.2K | 20 |
| 2023 | $222.20 | $114.88 | 1.93x | $107.32 | $3.2M | 27.7K | 17 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 21.8K | $16.0M | $734.95 | 1.72x |
| J2778 | Injection, ranibizumab, 0.1 mg | 14.4K | $3.8M | $265.90 | 1.91x |
| 67028 | Injection of drug into eye | 13.3K | $1.1M | $86.25 | 2.96x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 20.3K | $591.5K | $29.17 | 1.71x |
| 92134 | Imaging of retina | 14.0K | $388.2K | $27.72 | 2.82x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 2.4K | $380.3K | $156.11 | 1.85x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 4.2K | $226.4K | $54.35 | 2.82x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 2.5K | $205.6K | $81.95 | 2.68x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 179 | $111.6K | $623.44 | 2.70x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 124 | $107.4K | $866.48 | 2.61x |
| J3590 | Unclassified biologics | 1.7K | $105.8K | $64.06 | 4.03x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 875 | $101.6K | $116.14 | 2.69x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 116 | $99.7K | $859.52 | 2.53x |
| 67113 | Complex repair of detached retina and drainage of eye fluid between lens and retina | 80 | $75.0K | $938.11 | 2.68x |
| 67041 | Removal of membrane of retina | 78 | $64.4K | $825.15 | 2.60x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 228 | $63.8K | $279.82 | 2.97x |
| 92014 | Established patient complete exam of visual system | 638 | $52.0K | $81.57 | 2.85x |
| 92250 | Photography of the retina | 1.5K | $47.2K | $32.04 | 2.84x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 142 | $46.4K | $326.59 | 2.78x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 439 | $32.0K | $73.00 | 2.86x |
This provider submits charges 1.9 times higher than what Medicare actually pays.
A markup ratio of 1.9x means for every $100 Medicare pays, this provider initially charges $190. This is lower 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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