This provider averages 72 services per working day
Based on 179.7K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $27.5M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 72 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 279% from 2014 to 2023.
61% of their billing comes from a single procedure code (J0178 — Injection, aflibercept, 1 mg).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 79% in 2015
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 | $233.41 | $108.84 | 2.14x | $124.57 | $1.1M | 10.0K | 20 |
| 2015 | $255.77 | $121.14 | 2.11x | $134.63 | $1.9M | 16.1K | 18 |
| 2016 | $297.72 | $140.69 | 2.12x | $157.03 | $2.5M | 17.6K | 19 |
| 2017 | $324.21 | $150.05 | 2.16x | $174.16 | $2.6M | 17.4K | 21 |
| 2018 | $350.28 | $167.57 | 2.09x | $182.71 | $3.0M | 17.9K | 21 |
| 2019 | $375.32 | $178.06 | 2.11x | $197.26 | $2.5M | 14.3K | 21 |
| 2020 | $458.58 | $218.75 | 2.10x | $239.83 | $2.6M | 12.1K | 19 |
| 2021 | $477.67 | $228.42 | 2.09x | $249.25 | $3.3M | 14.4K | 21 |
| 2022 | $499.60 | $205.29 | 2.43x | $294.31 | $3.8M | 18.5K | 23 |
| 2023 | $205.25 | $99.72 | 2.06x | $105.53 | $4.1M | 41.3K | 24 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 22.9K | $16.8M | $734.02 | 1.95x |
| J2778 | Injection, ranibizumab, 0.1 mg | 7.3K | $2.1M | $286.31 | 2.30x |
| 67028 | Injection of drug into eye | 20.9K | $1.7M | $82.89 | 2.98x |
| 92014 | Established patient complete exam of visual system | 19.8K | $1.6M | $82.93 | 2.24x |
| 92134 | Imaging of retina | 32.8K | $951.7K | $29.01 | 2.76x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 28.4K | $828.0K | $29.17 | 1.71x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 4.4K | $677.0K | $154.42 | 1.95x |
| J9035 | Injection, bevacizumab, 10 mg | 8.7K | $482.0K | $55.21 | 2.10x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 545 | $481.0K | $882.57 | 2.72x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 4.2K | $474.6K | $113.40 | 1.90x |
| 92012 | Established patient problem focused exam of visual system | 4.0K | $239.3K | $59.26 | 2.01x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 427 | $159.6K | $373.84 | 5.32x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 478 | $157.3K | $329.08 | 2.95x |
| 92250 | Photography of the retina | 3.9K | $156.4K | $40.37 | 2.53x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 2.1K | $150.6K | $73.24 | 3.17x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 151 | $145.3K | $961.98 | 2.60x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina, complex | 82 | $83.7K | $1.0K | 2.74x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 3.4K | $67.2K | $19.99 | 3.73x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 49 | $32.0K | $653.87 | 2.47x |
| J3300 | Injection, triamcinolone acetonide, preservative free, 1 mg | 10.4K | $29.2K | $2.81 | 2.33x |
This provider submits charges 2.15 times higher than what Medicare actually pays.
A markup ratio of 2.15x means for every $100 Medicare pays, this provider initially charges $215. 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 OK for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Sumit Nanda, MD | Oklahoma City, OK | $40.7M | ✓ Clear |
Share this provider's Medicare payment information
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.
Believe this data is inaccurate? Dispute this data