This provider averages 148 services per working day
Based on 370.7K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $68.1M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 148 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 | $513.28 | $242.77 | 2.11x | $270.51 | $6.5M | 26.7K | 21 |
| 2015 | $559.86 | $265.10 | 2.11x | $294.76 | $7.4M | 27.8K | 25 |
| 2016 | $590.99 | $272.58 | 2.17x | $318.41 | $6.9M | 25.5K | 23 |
| 2017 | $608.60 | $282.69 | 2.15x | $325.91 | $7.2M | 25.3K | 21 |
| 2018 | $569.54 | $259.01 | 2.20x | $310.53 | $7.0M | 26.9K | 19 |
| 2019 | $589.21 | $266.79 | 2.21x | $322.42 | $7.1M | 26.5K | 20 |
| 2020 | $587.75 | $261.27 | 2.25x | $326.48 | $6.7M | 25.8K | 19 |
| 2021 | $584.20 | $257.45 | 2.27x | $326.75 | $7.9M | 30.7K | 23 |
| 2022 | $381.39 | $152.15 | 2.51x | $229.24 | $7.1M | 46.5K | 20 |
| 2023 | $109.64 | $40.16 | 2.73x | $69.48 | $4.4M | 109.0K | 16 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 48.2K | $36.3M | $753.48 | 1.66x |
| J2778 | Injection, ranibizumab, 0.1 mg | 63.2K | $17.5M | $276.21 | 1.88x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 123.1K | $3.6M | $29.33 | 2.56x |
| 67028 | Injection of drug into eye | 41.3K | $3.3M | $79.49 | 8.69x |
| J3590 | Unclassified biologics | 7.6K | $2.0M | $262.34 | 2.75x |
| 92134 | Imaging of retina | 49.3K | $1.5M | $30.17 | 3.65x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 15.8K | $1.2M | $73.74 | 2.52x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 4.5K | $695.4K | $154.99 | 1.65x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 490 | $439.5K | $896.86 | 4.68x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 1.4K | $357.4K | $251.32 | 2.39x |
| 92014 | Established patient complete exam of visual system | 3.0K | $244.5K | $82.70 | 3.56x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 4.1K | $214.5K | $52.63 | 2.50x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina, with removal of vitreous fluid | 123 | $119.5K | $971.87 | 4.22x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.1K | $119.0K | $111.74 | 2.47x |
| 92012 | Established patient problem focused exam of visual system | 1.5K | $83.2K | $56.76 | 3.21x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 858 | $64.7K | $75.36 | 3.39x |
| 67113 | Complex repair of detached retina and drainage of eye fluid between lens and retina | 58 | $62.7K | $1.1K | 4.16x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 107 | $62.7K | $586.04 | 5.63x |
| 92250 | Photography of the retina | 1.6K | $55.9K | $34.52 | 5.07x |
| 92004 | New patient complete exam of visual system | 532 | $54.5K | $102.41 | 3.22x |
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 |
|---|---|---|---|
| Kyle Alliman, M.D. | West Des Moines, IA | $83.3M | ✓ Clear |
| David Saggau, MD | West Des Moines, IA | $73.8M | ✓ 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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