This provider averages 67 services per working day
Based on 151.1K total services over 9 years (250 working days/year). Learn about impossible service volumes →
This provider's $26.5M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 67 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 247702% from 2015 to 2023.
71% of their billing comes from a single procedure code (J0178 — Injection, aflibercept, 1 mg).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1019% 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 |
|---|---|---|---|---|---|---|---|
| 2015 | $598.52 | $49.15 | 12.18x | $549.37 | $2.9K | 58 | 3 |
| 2016 | $3.7K | $74.13 | 50.21x | $3.6K | $20.5K | 276 | 8 |
| 2017 | $680.22 | $180.20 | 3.77x | $500.02 | $229.0K | 1.3K | 14 |
| 2018 | $558.55 | $251.35 | 2.22x | $307.20 | $1.8M | 7.0K | 16 |
| 2019 | $623.62 | $290.93 | 2.14x | $332.69 | $3.0M | 10.4K | 16 |
| 2020 | $635.68 | $289.84 | 2.19x | $345.84 | $3.6M | 12.3K | 16 |
| 2021 | $643.77 | $294.55 | 2.19x | $349.22 | $4.5M | 15.2K | 20 |
| 2022 | $507.36 | $222.42 | 2.28x | $284.94 | $6.3M | 28.5K | 21 |
| 2023 | $227.15 | $92.85 | 2.45x | $134.30 | $7.1M | 76.1K | 18 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 25.9K | $18.8M | $724.08 | 1.73x |
| J2778 | Injection, ranibizumab, 0.1 mg | 8.5K | $2.0M | $240.28 | 2.17x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 63.8K | $1.9M | $29.09 | 2.58x |
| 67028 | Injection of drug into eye | 15.6K | $1.3M | $84.39 | 8.09x |
| 92134 | Imaging of retina | 21.2K | $611.5K | $28.82 | 3.83x |
| J3590 | Unclassified biologics | 2.2K | $387.9K | $178.77 | 3.02x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 1.2K | $300.7K | $249.35 | 2.41x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 2.9K | $242.8K | $82.51 | 2.41x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 3.7K | $202.2K | $55.21 | 2.48x |
| 92014 | Established patient complete exam of visual system | 2.3K | $196.4K | $83.84 | 3.59x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 197 | $154.1K | $782.15 | 6.31x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 786 | $88.6K | $112.72 | 2.66x |
| 92004 | New patient complete exam of visual system | 651 | $66.3K | $101.80 | 3.51x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 86 | $48.9K | $568.23 | 13.30x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 122 | $37.1K | $304.31 | 4.43x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina, complex | 57 | $33.5K | $587.44 | 13.98x |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 592 | $20.7K | $35.00 | 2.54x |
| 66821 | Removal of recurring cataract in lens capsule using a laser | 71 | $18.0K | $253.43 | 3.82x |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 235 | $17.0K | $72.52 | 2.73x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 43 | $16.7K | $388.55 | 12.48x |
This provider submits charges 2.33 times higher than what Medicare actually pays.
A markup ratio of 2.33x means for every $100 Medicare pays, this provider initially charges $233. 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 |
|---|---|---|---|
| Kyle Alliman, M.D. | West Des Moines, IA | $83.3M | ✓ Clear |
| 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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