This provider averages 51 services per working day
Based on 128.7K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $19.2M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 51 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 400% from 2014 to 2023.
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 | $206.01 | $61.09 | 3.37x | $144.92 | $600.9K | 9.8K | 18 |
| 2015 | $242.24 | $73.43 | 3.30x | $168.81 | $744.2K | 10.1K | 17 |
| 2016 | $316.95 | $119.68 | 2.65x | $197.27 | $1.1M | 8.9K | 15 |
| 2017 | $379.07 | $156.66 | 2.42x | $222.41 | $1.5M | 9.5K | 17 |
| 2018 | $387.25 | $161.24 | 2.40x | $226.01 | $1.6M | 10.1K | 17 |
| 2019 | $390.56 | $162.78 | 2.40x | $227.78 | $2.3M | 13.9K | 18 |
| 2020 | $427.75 | $181.27 | 2.36x | $246.48 | $2.4M | 13.2K | 17 |
| 2021 | $480.95 | $198.46 | 2.42x | $282.49 | $2.8M | 13.9K | 16 |
| 2022 | $536.21 | $195.96 | 2.74x | $340.25 | $3.2M | 16.5K | 15 |
| 2023 | $447.04 | $132.44 | 3.38x | $314.60 | $3.0M | 22.7K | 16 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 14.7K | $10.7M | $727.32 | 1.81x |
| J2778 | Injection, ranibizumab, 0.1 mg | 10.2K | $2.5M | $240.73 | 2.09x |
| 67028 | Injection of drug into eye | 17.5K | $1.5M | $83.24 | 10.14x |
| 92012 | Established patient problem focused exam of visual system | 17.0K | $993.4K | $58.54 | 1.69x |
| 92134 | Imaging of retina | 19.9K | $583.9K | $29.29 | 3.09x |
| 92014 | Established patient complete exam of visual system | 6.5K | $515.2K | $79.63 | 1.86x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 12.5K | $350.6K | $27.96 | 3.88x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 1.6K | $338.6K | $217.61 | 5.91x |
| J9035 | Injection, bevacizumab, 10 mg | 5.6K | $335.9K | $59.82 | 1.79x |
| 92250 | Photography of the retina | 8.3K | $328.6K | $39.40 | 3.06x |
| J3590 | Unclassified biologics | 4.8K | $262.8K | $54.22 | 1.84x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 3.3K | $211.4K | $63.12 | 2.20x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.7K | $188.9K | $111.25 | 1.80x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 322 | $116.7K | $362.40 | 4.15x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 243 | $92.1K | $378.96 | 3.46x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 688 | $51.1K | $74.25 | 4.01x |
| J3490 | Unclassified drugs | 27 | $49.7K | $1.8K | 3.68x |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 1.2K | $39.5K | $33.24 | 1.50x |
| 67145 | Preventive retinal detachment treatment by heat or laser, 1 or more sessions | 82 | $32.1K | $391.35 | 3.22x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 1.3K | $22.6K | $16.96 | 4.18x |
This provider submits charges 2.69 times higher than what Medicare actually pays.
A markup ratio of 2.69x means for every $100 Medicare pays, this provider initially charges $269. 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 SC for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Eric Jablon, M.D. | Charleston, SC | $49.1M | ✓ Clear |
| John Wells, MD | West Columbia, SC | $38.6M | ✓ Clear |
| John Payne, MD | West Columbia, SC | $37.4M | ✓ Clear |
| John Kerrison, M.D. | Charleston, SC | $35.7M | ✓ Clear |
| David Johnson, MD | West Columbia, SC | $34.8M | ✓ 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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