This provider's $6.9M in total Medicare payments ranks in the 97th percentile of Ophthalmology providers nationally.
Their average markup ratio of 5.45x is significantly above the specialty median of 2.9x.
Medicare payments to this provider grew 69% from 2014 to 2023.
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 | $733.87 | $146.12 | 5.02x | $587.75 | $433.6K | 3.4K | 2.3K |
| 2015 | $796.59 | $145.73 | 5.47x | $650.86 | $593.0K | 4.5K | 3.0K |
| 2016 | $807.16 | $145.75 | 5.54x | $661.41 | $616.4K | 4.3K | 2.7K |
| 2017 | $871.89 | $150.44 | 5.80x | $721.45 | $607.1K | 4.0K | 2.4K |
| 2018 | $889.47 | $153.50 | 5.79x | $735.97 | $650.0K | 4.1K | 2.6K |
| 2019 | $1.2K | $166.09 | 7.04x | $1.0K | $861.2K | 5.2K | 3.2K |
| 2020 | $1.1K | $154.64 | 7.08x | $939.44 | $830.2K | 5.8K | 3.6K |
| 2021 | $1.1K | $159.43 | 6.67x | $904.04 | $785.4K | 5.5K | 3.6K |
| 2022 | $1.1K | $176.58 | 6.18x | $914.37 | $750.3K | 5.0K | 3.1K |
| 2023 | $1.0K | $169.40 | 6.18x | $878.16 | $731.5K | 5.0K | 3.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 3.7K | $2.8M | $739.29 | 4.89x |
| 66984 | Removal of cataract with insertion of lens | 4.2K | $1.1M | $269.51 | 5.22x |
| 67028 | Injection of drug into eye | 7.2K | $624.7K | $86.98 | 11.95x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 5.6K | $465.7K | $83.59 | 2.87x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 917 | $227.3K | $247.82 | 5.18x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.7K | $218.5K | $82.07 | 3.43x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 798 | $216.6K | $271.48 | 3.83x |
| 66982 | Removal of cataract with insertion of lens | 395 | $161.0K | $407.67 | 10.21x |
| 92134 | Diagnostic imaging of retina | 5.2K | $159.8K | $30.67 | 5.11x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.9K | $156.3K | $53.78 | 3.50x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 2.8K | $155.5K | $55.72 | 3.06x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 1.2K | $122.0K | $100.68 | 3.48x |
| 92136 | Measurement of corneal curvature and depth of eye | 2.9K | $117.6K | $41.07 | 6.30x |
| J7999 | Compounded drug, not otherwise classified | 1.6K | $72.4K | $44.14 | 2.39x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 409 | $43.2K | $105.67 | 4.22x |
| 92133 | Diagnostic imaging of optic nerve of eye | 1.4K | $37.3K | $25.95 | 5.61x |
| 92083 | Measurement of field of vision during daylight conditions | 903 | $36.6K | $40.55 | 5.59x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 110 | $30.5K | $277.04 | 14.56x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 57 | $29.3K | $513.32 | 3.44x |
| J9035 | Injection, bevacizumab, 10 mg | 546 | $28.2K | $51.62 | 4.07x |
This provider submits charges 5.45 times higher than what Medicare actually pays.
A markup ratio of 5.45x means for every $100 Medicare pays, this provider initially charges $545. 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 ND for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Max Johnson, MD | Fargo, ND | $37.3M | ✓ 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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