This provider's $7.2M in total Medicare payments ranks in the 97th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 60% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 59% 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 | $531.84 | $255.88 | 2.08x | $275.96 | $594.2K | 7.6K | 2.8K |
| 2015 | $491.34 | $198.66 | 2.47x | $292.68 | $581.4K | 7.5K | 2.9K |
| 2016 | $522.11 | $204.63 | 2.55x | $317.48 | $537.9K | 7.5K | 2.8K |
| 2017 | $648.66 | $238.09 | 2.72x | $410.57 | $556.4K | 7.2K | 2.9K |
| 2018 | $606.15 | $231.81 | 2.61x | $374.34 | $549.4K | 7.1K | 2.7K |
| 2019 | $623.62 | $206.71 | 3.02x | $416.91 | $874.7K | 11.2K | 4.1K |
| 2020 | $595.92 | $209.09 | 2.85x | $386.83 | $809.4K | 10.1K | 3.7K |
| 2021 | $475.99 | $178.93 | 2.66x | $297.06 | $878.7K | 10.0K | 3.5K |
| 2022 | $577.07 | $159.54 | 3.62x | $417.53 | $909.9K | 8.8K | 3.5K |
| 2023 | $782.71 | $161.04 | 4.86x | $621.67 | $948.6K | 8.9K | 3.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 2.3K | $1.7M | $735.32 | 2.46x |
| 67028 | Injection of drug into eye | 14.4K | $1.3M | $89.96 | 4.38x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 14.2K | $956.1K | $67.12 | 2.88x |
| 92134 | Diagnostic imaging of retina | 23.4K | $729.6K | $31.19 | 5.75x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 7.7K | $619.3K | $80.82 | 3.50x |
| J9035 | Injection, bevacizumab, 10 mg | 10.6K | $610.4K | $57.78 | 3.82x |
| 67042 | Removal of membrane from the retina, pars plana approach | 230 | $215.4K | $936.67 | 2.83x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 791 | $171.9K | $217.32 | 2.58x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 1.3K | $142.4K | $107.92 | 3.00x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 1.3K | $108.2K | $83.84 | 3.02x |
| 76512 | Ultrasound of eye disease, growth, or structure | 1.8K | $90.5K | $50.95 | 3.82x |
| 67145 | Preventive retinal detachment treatment by heat or laser, 1 or more sessions | 202 | $74.0K | $366.40 | 3.29x |
| 92250 | Photography of the retina | 1.5K | $64.9K | $44.57 | 3.33x |
| J2778 | Injection, ranibizumab, 0.1 mg | 292 | $63.9K | $218.83 | 2.47x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 403 | $63.7K | $158.17 | 2.02x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 51 | $58.6K | $1.1K | 2.87x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 146 | $58.3K | $399.46 | 2.53x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 95 | $56.2K | $591.82 | 3.10x |
| 92020 | Examination of cornea and iris using lens device and slit lamp | 2.6K | $52.7K | $20.65 | 3.27x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 38 | $26.6K | $699.37 | 2.57x |
This provider submits charges 3.49 times higher than what Medicare actually pays.
A markup ratio of 3.49x means for every $100 Medicare pays, this provider initially charges $349. 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 |
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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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