This provider averages 104 services per working day
Based on 259.5K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $37.2M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 104 services per working day raises questions about billing patterns.
61% of their billing comes from a single procedure code (J2778 — Injection, ranibizumab, 0.1 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 | $277.19 | $165.32 | 1.68x | $111.87 | $3.4M | 20.7K | 19 |
| 2015 | $269.19 | $158.17 | 1.70x | $111.02 | $3.4M | 21.4K | 20 |
| 2016 | $230.01 | $147.57 | 1.56x | $82.44 | $3.5M | 23.4K | 18 |
| 2017 | $197.89 | $144.03 | 1.37x | $53.86 | $3.2M | 22.3K | 17 |
| 2018 | $196.03 | $147.75 | 1.33x | $48.28 | $3.7M | 25.0K | 17 |
| 2019 | $195.97 | $145.61 | 1.35x | $50.36 | $4.0M | 27.3K | 18 |
| 2020 | $223.37 | $166.99 | 1.34x | $56.38 | $4.3M | 25.9K | 18 |
| 2021 | $210.55 | $157.20 | 1.34x | $53.35 | $4.5M | 28.7K | 20 |
| 2022 | $207.12 | $135.48 | 1.53x | $71.64 | $3.8M | 27.8K | 19 |
| 2023 | $130.90 | $92.68 | 1.41x | $38.22 | $3.4M | 36.9K | 19 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2778 | Injection, ranibizumab, 0.1 mg | 84.8K | $22.7M | $267.71 | 1.36x |
| J0178 | Injection, aflibercept, 1 mg | 6.0K | $4.4M | $739.65 | 1.30x |
| 67028 | Injection of drug into eye | 22.8K | $2.0M | $86.63 | 2.26x |
| 92014 | Established patient complete exam of visual system | 20.1K | $1.8M | $90.01 | 1.61x |
| 92134 | Imaging of retina | 45.1K | $1.4M | $30.64 | 1.59x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 13.3K | $1.1M | $84.01 | 1.67x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 1.9K | $416.6K | $214.17 | 1.31x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 2.6K | $411.9K | $157.76 | 1.59x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 5.7K | $374.1K | $65.61 | 1.66x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 2.7K | $353.4K | $129.18 | 1.59x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 4.6K | $340.1K | $74.33 | 1.32x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 11.1K | $313.0K | $28.20 | 1.34x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 3.7K | $311.1K | $83.41 | 2.01x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 15.6K | $307.0K | $19.65 | 1.47x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 264 | $275.8K | $1.0K | 1.65x |
| 92250 | Photography of the retina | 2.8K | $115.8K | $40.94 | 1.69x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 274 | $104.5K | $381.51 | 1.55x |
| 92202 | Extended exam of the back part of the eye with optic nerve drawing | 8.0K | $96.0K | $12.04 | 1.39x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 4.0K | $85.4K | $21.57 | 1.63x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina, with removal of vitreous fluid | 58 | $61.1K | $1.1K | 1.53x |
This provider submits charges 1.45 times higher than what Medicare actually pays.
A markup ratio of 1.45x means for every $100 Medicare pays, this provider initially charges $145. 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 IL for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Michael Mcclintock, M.D. | Chicago, IL | $34.3M | ✓ 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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