This provider averages 197 services per working day
Based on 492.5K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $83.3M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 197 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 | $433.80 | $200.26 | 2.17x | $233.54 | $6.1M | 30.4K | 18 |
| 2015 | $531.93 | $249.53 | 2.13x | $282.40 | $7.5M | 29.9K | 22 |
| 2016 | $565.51 | $263.05 | 2.15x | $302.46 | $7.9M | 30.1K | 22 |
| 2017 | $578.12 | $269.85 | 2.14x | $308.27 | $8.2M | 30.5K | 21 |
| 2018 | $575.68 | $265.15 | 2.17x | $310.53 | $8.2M | 31.0K | 21 |
| 2019 | $594.35 | $273.21 | 2.18x | $321.14 | $9.1M | 33.2K | 20 |
| 2020 | $623.83 | $282.87 | 2.21x | $340.96 | $9.0M | 31.8K | 20 |
| 2021 | $617.91 | $277.22 | 2.23x | $340.69 | $9.7M | 34.9K | 24 |
| 2022 | $466.83 | $197.46 | 2.36x | $269.37 | $8.9M | 45.0K | 21 |
| 2023 | $122.48 | $44.56 | 2.75x | $77.92 | $8.7M | 195.8K | 20 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 59.1K | $44.1M | $745.97 | 1.68x |
| J2778 | Injection, ranibizumab, 0.1 mg | 82.0K | $22.5M | $274.97 | 1.89x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 188.8K | $5.5M | $29.13 | 2.57x |
| 67028 | Injection of drug into eye | 49.2K | $4.0M | $81.21 | 8.65x |
| 92134 | Imaging of retina | 62.0K | $1.9M | $30.04 | 3.66x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 17.5K | $1.3M | $73.81 | 2.53x |
| J3590 | Unclassified biologics | 7.4K | $1.2M | $157.83 | 2.92x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 1.8K | $453.1K | $250.06 | 2.40x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 8.3K | $449.8K | $54.17 | 2.43x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 2.7K | $431.9K | $157.81 | 1.64x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 486 | $429.0K | $882.76 | 4.76x |
| 92014 | Established patient complete exam of visual system | 3.1K | $259.4K | $83.67 | 3.51x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.3K | $140.6K | $110.03 | 2.51x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 149 | $135.9K | $912.20 | 4.49x |
| 66821 | Removal of recurring cataract in lens capsule using a laser | 323 | $69.5K | $215.14 | 3.75x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 109 | $62.7K | $575.63 | 5.73x |
| 92004 | New patient complete exam of visual system | 568 | $57.7K | $101.52 | 3.26x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 717 | $54.2K | $75.62 | 3.38x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 128 | $44.6K | $348.36 | 3.64x |
| 92250 | Photography of the retina | 1.2K | $40.7K | $34.69 | 5.04x |
This provider submits charges 2.25 times higher than what Medicare actually pays.
A markup ratio of 2.25x means for every $100 Medicare pays, this provider initially charges $225. 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 IA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| David Saggau, MD | West Des Moines, IA | $73.8M | ✓ Clear |
| Jared Nielsen, M.D., M.S. | West Des Moines, IA | $68.1M | ✓ Clear |
| Alex Kartvelishvili, M.D. | Iowa City, IA | $45.0M | ✓ Clear |
| Michael Wadzinski, M.D. | Sioux City, IA | $37.7M | ✓ 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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