This provider averages 94 services per working day
Based on 235.1K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $39.4M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 94 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 | $345.35 | $207.24 | 1.67x | $138.11 | $3.5M | 16.8K | 19 |
| 2015 | $331.81 | $195.67 | 1.70x | $136.14 | $3.6M | 18.5K | 18 |
| 2016 | $330.59 | $193.31 | 1.71x | $137.28 | $4.0M | 20.7K | 18 |
| 2017 | $337.61 | $195.57 | 1.73x | $142.04 | $4.5M | 23.0K | 15 |
| 2018 | $352.94 | $205.04 | 1.72x | $147.90 | $4.9M | 23.7K | 16 |
| 2019 | $351.32 | $199.99 | 1.76x | $151.33 | $4.3M | 21.3K | 16 |
| 2020 | $401.06 | $226.77 | 1.77x | $174.29 | $3.7M | 16.1K | 15 |
| 2021 | $428.12 | $242.32 | 1.77x | $185.80 | $3.8M | 15.6K | 19 |
| 2022 | $300.61 | $162.68 | 1.85x | $137.93 | $3.6M | 21.9K | 17 |
| 2023 | $117.68 | $63.86 | 1.84x | $53.82 | $3.7M | 57.6K | 20 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2778 | Injection, ranibizumab, 0.1 mg | 66.7K | $18.9M | $282.95 | 1.65x |
| J0178 | Injection, aflibercept, 1 mg | 15.0K | $11.1M | $739.00 | 1.46x |
| 67028 | Injection of drug into eye | 19.7K | $1.9M | $95.46 | 3.32x |
| 92014 | Established patient complete exam of visual system | 20.5K | $1.8M | $89.86 | 1.96x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 54.6K | $1.6M | $29.02 | 1.55x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 5.5K | $869.5K | $157.40 | 1.31x |
| 92134 | Imaging of retina | 22.7K | $717.8K | $31.57 | 2.54x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 5.9K | $566.4K | $96.34 | 2.15x |
| J3590 | Unclassified biologics | 815 | $333.0K | $408.58 | 1.91x |
| 92250 | Photography of the retina | 7.1K | $282.4K | $39.98 | 3.59x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 3.2K | $268.5K | $84.83 | 3.10x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 228 | $223.6K | $980.55 | 2.40x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 1.4K | $149.5K | $108.58 | 1.84x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 7.5K | $146.7K | $19.57 | 2.83x |
| J3490 | Unclassified drugs | 63 | $118.5K | $1.9K | 1.42x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 188 | $113.1K | $601.52 | 2.66x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 175 | $98.9K | $565.04 | 2.31x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 554 | $67.0K | $120.91 | 2.08x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 196 | $32.8K | $167.43 | 1.96x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 1.3K | $27.4K | $21.37 | 2.84x |
This provider submits charges 1.75 times higher than what Medicare actually pays.
A markup ratio of 1.75x means for every $100 Medicare pays, this provider initially charges $175. 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 MI for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Sandeep Randhawa, MD | Royal Oak, MI | $44.6M | ✓ Clear |
| Scott Sneed, MD | Traverse City, MI | $39.4M | ✓ Clear |
| Douglas Covert, MD, MPH | Traverse City, MI | $34.7M | ✓ 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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