This provider's $7.4M in total Medicare payments ranks in the 97th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 8062% from 2018 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 479% 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 |
|---|---|---|---|---|---|---|---|
| 2018 | $437.67 | $171.84 | 2.55x | $265.83 | $39.9K | 232 | 5 |
| 2019 | $408.80 | $157.57 | 2.59x | $251.23 | $101.5K | 644 | 8 |
| 2020 | $678.71 | $170.55 | 3.98x | $508.16 | $228.9K | 1.3K | 13 |
| 2021 | $679.53 | $166.28 | 4.09x | $513.25 | $1.3M | 8.0K | 15 |
| 2022 | $777.02 | $181.05 | 4.29x | $595.97 | $2.5M | 13.7K | 16 |
| 2023 | $604.04 | $142.49 | 4.24x | $461.55 | $3.3M | 22.8K | 19 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 4.7K | $3.3M | $706.00 | 3.49x |
| J2778 | Injection, ranibizumab, 0.1 mg | 6.4K | $1.4M | $219.13 | 4.56x |
| 92014 | Established patient complete exam of visual system | 6.4K | $685.4K | $106.76 | 3.13x |
| 67028 | Injection of drug into eye | 4.5K | $471.8K | $104.98 | 5.61x |
| 92134 | Imaging of retina | 7.2K | $253.8K | $35.48 | 12.06x |
| J3590 | Unclassified biologics | 106 | $245.9K | $2.3K | 3.09x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 8.1K | $235.9K | $29.12 | 4.29x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 1.1K | $235.4K | $215.94 | 4.63x |
| J3490 | Unclassified drugs | 78 | $141.6K | $1.8K | 3.21x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 849 | $113.4K | $133.51 | 3.16x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 705 | $84.9K | $120.36 | 3.05x |
| J7999 | Compounded drug, not otherwise classified | 662 | $49.8K | $75.20 | 9.81x |
| 92202 | Extended exam of the back part of the eye with optic nerve drawing | 3.4K | $45.7K | $13.35 | 6.74x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 268 | $29.7K | $110.72 | 3.19x |
| 92250 | Photography of the retina | 640 | $20.7K | $32.39 | 5.93x |
| 92201 | Extended exam of the back part of the eye with retinal drawing | 909 | $19.2K | $21.13 | 4.20x |
| 92012 | Established patient problem focused exam of visual system | 169 | $13.1K | $77.67 | 2.80x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 78 | $8.5K | $108.73 | 2.63x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 11 | $8.1K | $735.26 | 3.23x |
| 76512 | 2d ultrasound scan of eye tissue and structures | 177 | $8.0K | $45.10 | 6.25x |
This provider submits charges 4.19 times higher than what Medicare actually pays.
A markup ratio of 4.19x means for every $100 Medicare pays, this provider initially charges $419. 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 MO for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Stephen Wiles, MD | Kansas City, MO | $44.4M | ✓ Clear |
| Mari Keithahn, M.D. | Columbia, MO | $44.2M | ✓ 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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