This provider's $4.8M in total Medicare payments ranks in the 96th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 1411% from 2015 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 269% in 2016
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 | $305.66 | $169.53 | 1.80x | $136.13 | $53.2K | 624 | 415 |
| 2016 | $265.70 | $132.32 | 2.01x | $133.38 | $196.0K | 2.0K | 881 |
| 2017 | $304.40 | $139.80 | 2.18x | $164.60 | $162.1K | 2.1K | 1.1K |
| 2018 | $314.50 | $126.43 | 2.49x | $188.07 | $223.1K | 2.3K | 1.4K |
| 2019 | $807.23 | $217.97 | 3.70x | $589.26 | $565.9K | 5.5K | 2.6K |
| 2020 | $720.34 | $209.13 | 3.44x | $511.21 | $644.6K | 5.9K | 2.8K |
| 2021 | $658.63 | $180.68 | 3.65x | $477.95 | $715.9K | 6.2K | 2.9K |
| 2022 | $883.52 | $255.87 | 3.45x | $627.65 | $1.5M | 11.1K | 5.3K |
| 2023 | $829.10 | $222.48 | 3.73x | $606.62 | $803.8K | 7.8K | 3.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 2.7K | $2.0M | $726.20 | 1.79x |
| 67028 | Injection of drug into eye | 9.1K | $768.2K | $84.38 | 7.86x |
| 92134 | Diagnostic imaging of retina | 15.1K | $430.4K | $28.45 | 4.95x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 4.6K | $394.2K | $85.70 | 2.77x |
| J9035 | Injection, bevacizumab, 10 mg | 4.2K | $238.2K | $56.86 | 1.84x |
| J3590 | Unclassified biologics | 135 | $201.6K | $1.5K | 1.87x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 1.7K | $172.7K | $103.53 | 2.85x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 2.0K | $123.4K | $60.72 | 2.79x |
| 67042 | Removal of membrane from the retina, pars plana approach | 124 | $104.1K | $839.16 | 4.17x |
| J2778 | Injection, ranibizumab, 0.1 mg | 361 | $87.0K | $241.11 | 2.07x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 81 | $71.8K | $886.73 | 3.95x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 339 | $53.1K | $156.59 | 1.60x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 169 | $36.2K | $214.24 | 1.86x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 122 | $30.5K | $250.29 | 7.99x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 307 | $24.8K | $80.83 | 4.30x |
| 92250 | Photography of the retina | 494 | $19.1K | $38.66 | 3.44x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 29 | $17.2K | $593.68 | 4.21x |
| J3490 | Unclassified drugs | 463 | $14.3K | $30.93 | 3.23x |
| 67040 | Destruction of eye fluid (vitreous) between lens and retina and all of retina using a laser | 12 | $9.2K | $766.16 | 3.92x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 305 | $8.9K | $29.15 | 1.89x |
This provider submits charges 3.37 times higher than what Medicare actually pays.
A markup ratio of 3.37x means for every $100 Medicare pays, this provider initially charges $337. 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 |
|---|---|---|---|
| Roy Wallace, MD | Nashville, TN | $48.8M | ✓ Clear |
| 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 |
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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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