This provider averages 68 services per working day
Based on 170.2K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $32.2M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 68 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 80% from 2014 to 2023.
66% 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 57% in 2019
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 | $208.34 | $141.58 | 1.47x | $66.76 | $2.1M | 14.5K | 18 |
| 2015 | $227.73 | $144.23 | 1.58x | $83.50 | $2.3M | 15.7K | 16 |
| 2016 | $265.75 | $164.42 | 1.62x | $101.33 | $2.4M | 14.8K | 16 |
| 2017 | $271.97 | $170.63 | 1.59x | $101.34 | $2.5M | 14.7K | 14 |
| 2018 | $305.38 | $189.95 | 1.61x | $115.43 | $2.8M | 14.7K | 14 |
| 2019 | $330.17 | $203.79 | 1.62x | $126.38 | $4.4M | 21.5K | 17 |
| 2020 | $370.26 | $226.99 | 1.63x | $143.27 | $4.0M | 17.6K | 14 |
| 2021 | $427.96 | $261.59 | 1.64x | $166.37 | $4.2M | 16.1K | 16 |
| 2022 | $628.17 | $231.80 | 2.71x | $396.37 | $3.9M | 16.6K | 16 |
| 2023 | $697.87 | $155.62 | 4.48x | $542.25 | $3.7M | 23.8K | 14 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 28.5K | $21.1M | $739.81 | 2.04x |
| J2778 | Injection, ranibizumab, 0.1 mg | 12.2K | $3.4M | $276.02 | 1.85x |
| 67028 | Injection of drug into eye | 27.2K | $2.5M | $91.00 | 2.37x |
| 92012 | Established patient problem focused exam of visual system | 18.3K | $1.2M | $63.22 | 1.76x |
| 92134 | Imaging of retina | 34.4K | $1.1M | $31.26 | 2.00x |
| J9035 | Injection, bevacizumab, 10 mg | 16.7K | $961.4K | $57.64 | 2.61x |
| 92014 | Established patient complete exam of visual system | 6.0K | $547.4K | $90.98 | 2.02x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 14.0K | $410.7K | $29.25 | 3.95x |
| 67041 | Removal of membrane of retina | 201 | $184.3K | $916.91 | 1.61x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 1.1K | $174.2K | $157.51 | 2.40x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 779 | $168.4K | $216.23 | 2.59x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.1K | $126.2K | $120.19 | 1.95x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 1.0K | $118.6K | $113.60 | 1.65x |
| 92004 | New patient complete exam of visual system | 886 | $97.2K | $109.72 | 1.75x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 122 | $56.7K | $465.07 | 1.51x |
| 92250 | Photography of the retina | 1.0K | $46.0K | $45.08 | 1.52x |
| 67042 | Removal of membrane from the retina, pars plana approach | 43 | $38.8K | $901.48 | 1.37x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 76 | $28.9K | $380.31 | 1.90x |
| 76512 | 2d ultrasound scan of eye tissue and structures | 373 | $20.6K | $55.10 | 2.01x |
| J3300 | Injection, triamcinolone acetonide, preservative free, 1 mg | 5.9K | $17.0K | $2.88 | 1.28x |
This provider submits charges 2.07 times higher than what Medicare actually pays.
A markup ratio of 2.07x means for every $100 Medicare pays, this provider initially charges $207. 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 MN for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| David Williams, MD | Edina, MN | $42.6M | ✓ Clear |
| Sundeep Dev, MD | Minneapolis, MN | $34.6M | ✓ Clear |
Share this provider's Medicare payment information
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.
Believe this data is inaccurate? Dispute this data