This provider averages 95 services per working day
Based on 238.6K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $48.8M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 95 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 | $666.61 | $200.03 | 3.33x | $466.58 | $4.0M | 20.1K | 17 |
| 2015 | $766.51 | $230.23 | 3.33x | $536.28 | $4.2M | 18.3K | 17 |
| 2016 | $786.97 | $233.97 | 3.36x | $553.00 | $4.3M | 18.3K | 16 |
| 2017 | $783.09 | $231.51 | 3.38x | $551.58 | $4.8M | 20.8K | 15 |
| 2018 | $768.90 | $226.03 | 3.40x | $542.87 | $5.1M | 22.8K | 14 |
| 2019 | $832.88 | $226.44 | 3.68x | $606.44 | $5.4M | 23.7K | 13 |
| 2020 | $878.58 | $234.83 | 3.74x | $643.75 | $5.1M | 21.5K | 10 |
| 2021 | $889.86 | $233.39 | 3.81x | $656.47 | $5.3M | 22.6K | 11 |
| 2022 | $917.04 | $209.90 | 4.37x | $707.14 | $5.2M | 24.6K | 13 |
| 2023 | $551.65 | $118.88 | 4.64x | $432.77 | $5.4M | 45.8K | 14 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 32.7K | $24.0M | $733.35 | 3.57x |
| J2778 | Injection, ranibizumab, 0.1 mg | 58.2K | $16.1M | $276.33 | 3.58x |
| 92014 | Established patient complete exam of visual system | 31.0K | $2.5M | $81.93 | 3.80x |
| 67028 | Injection of drug into eye | 28.3K | $2.3M | $80.97 | 6.54x |
| 92134 | Imaging of retina | 39.9K | $1.2M | $29.78 | 3.70x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 30.1K | $868.5K | $28.89 | 3.27x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 2.1K | $440.1K | $212.01 | 3.96x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 3.0K | $317.2K | $106.90 | 3.89x |
| J9035 | Injection, bevacizumab, 10 mg | 4.2K | $237.0K | $56.75 | 3.00x |
| 92012 | Established patient problem focused exam of visual system | 3.3K | $179.4K | $54.75 | 3.99x |
| 67042 | Removal of membrane from the retina, pars plana approach with removal of internal limiting membrane of retina | 162 | $139.2K | $858.98 | 3.32x |
| 92250 | Photography of the retina | 3.4K | $119.1K | $35.49 | 5.13x |
| 92235 | Imaging of blood vessels in back of eye using fluorescein dye | 1.2K | $81.7K | $69.31 | 3.69x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 173 | $75.8K | $438.12 | 5.25x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 73 | $66.2K | $906.98 | 4.23x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 95 | $58.5K | $615.62 | 3.51x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 112 | $41.5K | $370.96 | 3.32x |
| Q5124 | Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg | 205 | $36.5K | $178.10 | 3.16x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 203 | $31.9K | $157.25 | 3.21x |
| J3490 | Unclassified drugs | 13 | $23.6K | $1.8K | 3.14x |
This provider submits charges 3.74 times higher than what Medicare actually pays.
A markup ratio of 3.74x means for every $100 Medicare pays, this provider initially charges $374. 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 TN for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Carl Awh, M.D. | Nashville, TN | $48.0M | ✓ Clear |
| David Reichstein, M.D | Nashville, TN | $40.5M | ✓ Clear |
| Brandon Busbee, M.D. | Nashville, TN | $40.2M | ✓ Clear |
| Franco Recchia, MD | Nashville, TN | $39.8M | ✓ Clear |
| Everton Arrindell, M.D. | Nashville, TN | $36.8M | ✓ 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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