This provider's $9.1M in total Medicare payments ranks in the 98th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 138% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 83% in 2021
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 |
|---|---|---|---|---|---|---|---|
| 2014 | $311.51 | $167.47 | 1.86x | $144.04 | $535.1K | 4.8K | 3.5K |
| 2015 | $273.31 | $152.78 | 1.79x | $120.53 | $529.1K | 4.9K | 3.5K |
| 2016 | $260.63 | $150.31 | 1.73x | $110.32 | $529.5K | 5.0K | 3.4K |
| 2017 | $337.74 | $200.25 | 1.69x | $137.49 | $648.6K | 5.7K | 3.5K |
| 2018 | $359.91 | $198.48 | 1.81x | $161.43 | $650.7K | 5.8K | 3.5K |
| 2019 | $362.93 | $198.53 | 1.83x | $164.40 | $703.0K | 6.0K | 3.6K |
| 2020 | $290.52 | $190.09 | 1.53x | $100.43 | $943.7K | 7.5K | 4.4K |
| 2021 | $303.49 | $196.92 | 1.54x | $106.57 | $1.7M | 12.4K | 5.6K |
| 2022 | $404.00 | $233.80 | 1.73x | $170.20 | $1.6M | 10.9K | 4.9K |
| 2023 | $383.09 | $203.50 | 1.88x | $179.59 | $1.3M | 10.1K | 4.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 5.6K | $2.5M | $444.69 | 1.46x |
| J0178 | Injection, aflibercept, 1 mg | 2.9K | $2.1M | $721.56 | 1.56x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 14.4K | $909.9K | $63.29 | 1.64x |
| 67028 | Injection of drug into eye | 8.3K | $715.3K | $85.95 | 1.61x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 1.6K | $473.8K | $295.00 | 1.72x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 6.0K | $466.4K | $78.08 | 1.85x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 3.6K | $351.4K | $97.55 | 1.68x |
| 92134 | Diagnostic imaging of retina | 10.9K | $307.0K | $28.19 | 1.75x |
| 92136 | Measurement of corneal curvature and depth of eye | 6.3K | $225.1K | $35.99 | 2.22x |
| J7999 | Compounded drug, not otherwise classified | 3.0K | $202.4K | $68.29 | 1.52x |
| 66982 | Removal of cataract with insertion of lens | 297 | $172.2K | $579.85 | 1.50x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 193 | $116.7K | $604.58 | 2.10x |
| J9035 | Injection, bevacizumab, 10 mg | 2.2K | $116.2K | $53.16 | 1.51x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 3.5K | $97.3K | $27.60 | 1.77x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 156 | $81.1K | $519.69 | 1.79x |
| 66989 | Complex extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 101 | $65.6K | $649.82 | 1.46x |
| 0191T | Internal insertion of eye fluid drainage device | 275 | $57.6K | $209.36 | 1.36x |
| 92083 | Measurement of field of vision during daylight conditions | 1.4K | $53.2K | $39.39 | 1.80x |
| 67904 | Repair of tendon of upper eyelid | 66 | $41.3K | $625.99 | 2.12x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 150 | $38.1K | $254.33 | 1.85x |
This provider submits charges 1.61 times higher than what Medicare actually pays.
A markup ratio of 1.61x means for every $100 Medicare pays, this provider initially charges $161. 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 SD for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Prema Abraham, MD | Rapid City, SD | $39.1M | ✓ 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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