This provider averages 83 services per working day
Based on 166.9K total services over 8 years (250 working days/year). Learn about impossible service volumes →
This provider's $21.4M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 83 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 17895% from 2016 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1841% in 2017
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 |
|---|---|---|---|---|---|---|---|
| 2016 | $308.26 | $87.26 | 3.53x | $221.00 | $23.7K | 272 | 6 |
| 2017 | $446.93 | $270.74 | 1.65x | $176.19 | $460.8K | 1.7K | 11 |
| 2018 | $401.35 | $267.70 | 1.50x | $133.65 | $2.1M | 7.8K | 12 |
| 2019 | $373.40 | $238.32 | 1.57x | $135.08 | $3.6M | 15.1K | 19 |
| 2020 | $377.70 | $237.60 | 1.59x | $140.10 | $3.8M | 16.1K | 21 |
| 2021 | $433.45 | $270.82 | 1.60x | $162.63 | $3.7M | 13.6K | 21 |
| 2022 | $234.07 | $147.24 | 1.59x | $86.83 | $3.4M | 23.2K | 22 |
| 2023 | $75.50 | $47.92 | 1.58x | $27.58 | $4.3M | 89.1K | 24 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 13.6K | $9.8M | $725.45 | 1.55x |
| J2778 | Injection, ranibizumab, 0.1 mg | 17.7K | $4.7M | $267.05 | 1.72x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 90.5K | $2.5M | $27.93 | 1.50x |
| 67028 | Injection of drug into eye | 12.6K | $1.1M | $89.91 | 1.54x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 3.0K | $463.5K | $153.62 | 2.02x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 1.6K | $391.7K | $251.12 | 1.41x |
| 92134 | Imaging of retina | 12.4K | $371.8K | $30.00 | 1.44x |
| 92014 | Established patient complete exam of visual system | 3.8K | $341.6K | $89.54 | 1.50x |
| J3590 | Unclassified biologics | 205 | $338.8K | $1.7K | 1.38x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 239 | $180.3K | $754.28 | 1.43x |
| 92012 | Established patient problem focused exam of visual system | 2.8K | $179.9K | $63.51 | 1.45x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.5K | $174.7K | $120.29 | 1.39x |
| J7999 | Compounded drug, not otherwise classified | 1.7K | $116.8K | $69.62 | 1.76x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 115 | $89.6K | $778.70 | 1.52x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1.3K | $80.8K | $64.17 | 1.45x |
| J3490 | Unclassified drugs | 43 | $58.3K | $1.4K | 1.32x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 481 | $57.9K | $120.36 | 1.29x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 93 | $54.4K | $584.82 | 1.68x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 139 | $36.1K | $259.99 | 1.57x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 330 | $28.8K | $87.14 | 1.32x |
This provider submits charges 1.58 times higher than what Medicare actually pays.
A markup ratio of 1.58x means for every $100 Medicare pays, this provider initially charges $158. 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 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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