This provider averages 87 services per working day
Based on 216.5K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $30.8M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 87 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 125% from 2014 to 2023.
67% of their billing comes from a single procedure code (J0178 — Injection, aflibercept, 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 | $356.55 | $110.84 | 3.22x | $245.71 | $1.7M | 15.0K | 20 |
| 2015 | $389.32 | $128.37 | 3.03x | $260.95 | $2.2M | 17.2K | 20 |
| 2016 | $353.74 | $108.50 | 3.26x | $245.24 | $2.1M | 19.3K | 21 |
| 2017 | $232.98 | $117.64 | 1.98x | $115.34 | $2.3M | 19.9K | 27 |
| 2018 | $378.78 | $199.65 | 1.90x | $179.13 | $3.3M | 16.5K | 25 |
| 2019 | $433.07 | $226.95 | 1.91x | $206.12 | $3.9M | 17.0K | 26 |
| 2020 | $499.45 | $262.28 | 1.90x | $237.17 | $3.8M | 14.4K | 23 |
| 2021 | $513.80 | $268.36 | 1.91x | $245.44 | $4.0M | 14.8K | 20 |
| 2022 | $325.81 | $171.21 | 1.90x | $154.60 | $3.9M | 22.7K | 20 |
| 2023 | $118.72 | $62.62 | 1.90x | $56.10 | $3.7M | 59.6K | 19 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 27.6K | $20.3M | $735.16 | 1.64x |
| 67028 | Injection of drug into eye | 23.7K | $1.8M | $76.65 | 5.54x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 58.5K | $1.7M | $29.09 | 1.62x |
| J2778 | Injection, ranibizumab, 0.1 mg | 5.2K | $1.3M | $255.18 | 2.04x |
| 92014 | Established patient complete exam of visual system | 16.2K | $1.3M | $78.39 | 2.28x |
| 92134 | Imaging of retina | 30.9K | $911.9K | $29.52 | 3.94x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 5.1K | $360.0K | $70.66 | 3.67x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 2.2K | $333.6K | $151.30 | 2.12x |
| 67210 | Destruction of growth of retina using a laser | 877 | $328.2K | $374.27 | 3.81x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 2.4K | $273.0K | $112.25 | 2.50x |
| J3590 | Unclassified biologics | 4.9K | $261.2K | $52.98 | 4.25x |
| 92250 | Photography of the retina | 5.6K | $230.3K | $40.86 | 2.83x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 596 | $217.0K | $364.15 | 5.35x |
| J9035 | Injection, bevacizumab, 10 mg | 3.3K | $190.0K | $57.51 | 4.12x |
| J3490 | Unclassified drugs | 99 | $185.7K | $1.9K | 1.55x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 194 | $175.3K | $903.55 | 4.08x |
| 92012 | Established patient problem focused exam of visual system | 2.8K | $160.1K | $57.56 | 2.28x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 1.7K | $143.6K | $82.40 | 2.35x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 504 | $123.4K | $244.76 | 1.67x |
| J3396 | Injection, verteporfin, 0.1 mg | 13.7K | $116.0K | $8.47 | 1.41x |
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 WV for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Gary Miller, MD | Morgantown, WV | $39.6M | ✓ 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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