This provider averages 66 services per working day
Based on 164.7K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $46.6M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 66 services per working day raises questions about billing patterns.
79% of their billing comes from a single procedure code (J0178 — Injection, aflibercept, 1 mg).
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 | $432.63 | $254.74 | 1.70x | $177.89 | $3.6M | 14.0K | 20 |
| 2015 | $473.43 | $276.83 | 1.71x | $196.60 | $3.8M | 13.7K | 19 |
| 2016 | $505.83 | $292.90 | 1.73x | $212.93 | $4.1M | 14.1K | 21 |
| 2017 | $514.18 | $298.93 | 1.72x | $215.25 | $4.7M | 15.7K | 17 |
| 2018 | $517.03 | $298.04 | 1.73x | $218.99 | $5.1M | 17.1K | 18 |
| 2019 | $523.03 | $297.59 | 1.76x | $225.44 | $5.3M | 18.0K | 16 |
| 2020 | $552.11 | $311.21 | 1.77x | $240.90 | $5.3M | 17.2K | 15 |
| 2021 | $561.74 | $317.14 | 1.77x | $244.60 | $5.2M | 16.5K | 16 |
| 2022 | $558.83 | $308.99 | 1.81x | $249.84 | $4.7M | 15.3K | 15 |
| 2023 | $381.45 | $201.92 | 1.89x | $179.53 | $4.7M | 23.2K | 16 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 49.5K | $36.7M | $741.70 | 1.55x |
| J2778 | Injection, ranibizumab, 0.1 mg | 8.2K | $2.4M | $286.97 | 1.46x |
| 67028 | Injection of drug into eye | 25.0K | $2.2M | $88.47 | 4.62x |
| 92014 | Established patient complete exam of visual system | 15.2K | $1.3M | $87.47 | 1.83x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 6.5K | $1.0M | $156.18 | 1.41x |
| 92134 | Imaging of retina | 24.9K | $755.5K | $30.34 | 2.97x |
| 92250 | Photography of the retina | 15.5K | $686.6K | $44.27 | 2.94x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 3.0K | $354.5K | $116.82 | 1.80x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 258 | $241.3K | $935.08 | 2.46x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 8.0K | $231.3K | $28.98 | 1.76x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 3.3K | $171.3K | $52.27 | 2.58x |
| J9035 | Injection, bevacizumab, 10 mg | 2.0K | $103.4K | $52.03 | 1.54x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 72 | $74.0K | $1.0K | 2.67x |
| J3590 | Unclassified biologics | 1.2K | $59.7K | $49.95 | 1.30x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 122 | $49.0K | $401.66 | 4.96x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 120 | $47.8K | $397.94 | 3.20x |
| 67041 | Removal of membrane from the retina | 45 | $42.0K | $932.87 | 2.22x |
| 67145 | Preventive retinal detachment treatment by heat or laser, 1 or more sessions | 82 | $34.5K | $420.57 | 2.79x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 350 | $28.8K | $82.23 | 2.14x |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 352 | $25.4K | $72.06 | 2.15x |
This provider submits charges 1.76 times higher than what Medicare actually pays.
A markup ratio of 1.76x means for every $100 Medicare pays, this provider initially charges $176. This is lower 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 VA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Timothy Byrnes, MD | Roanoke, VA | $53.3M | ✓ Clear |
| James Tiedeman | Fishersville, VA | $51.1M | ✓ Clear |
| Kapil Kapoor, MD | Norfolk, VA | $43.0M | ✓ Clear |
| Alan Wagner, MD | Norfolk, VA | $42.8M | ✓ Clear |
| Mohit Nanda, MD | Charlottesville, VA | $41.2M | ✓ 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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