This provider averages 92 services per working day
Based on 229.3K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $27.8M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 92 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 85% 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 | $609.39 | $256.99 | 2.37x | $352.40 | $2.1M | 8.3K | 17 |
| 2015 | $609.45 | $245.37 | 2.48x | $364.08 | $2.0M | 8.2K | 19 |
| 2016 | $623.05 | $250.54 | 2.49x | $372.51 | $2.2M | 9.0K | 19 |
| 2017 | $638.08 | $257.89 | 2.47x | $380.19 | $2.5M | 9.6K | 17 |
| 2018 | $607.26 | $241.88 | 2.51x | $365.38 | $2.6M | 10.6K | 18 |
| 2019 | $606.23 | $238.67 | 2.54x | $367.56 | $2.7M | 11.2K | 20 |
| 2020 | $661.73 | $267.36 | 2.48x | $394.37 | $2.9M | 10.8K | 14 |
| 2021 | $637.39 | $255.02 | 2.50x | $382.37 | $3.1M | 12.1K | 17 |
| 2022 | $253.37 | $101.52 | 2.50x | $151.85 | $3.7M | 36.9K | 18 |
| 2023 | $70.98 | $34.93 | 2.03x | $36.05 | $3.9M | 112.6K | 15 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 22.2K | $16.6M | $747.29 | 1.61x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 131.9K | $3.9M | $29.22 | 1.59x |
| J2778 | Injection, ranibizumab, 0.1 mg | 6.4K | $1.8M | $281.56 | 1.72x |
| 67028 | Injection of drug into eye | 21.8K | $1.8M | $82.51 | 10.89x |
| J3590 | Unclassified biologics | 9.7K | $1.1M | $111.27 | 1.93x |
| 92012 | Established patient problem focused exam of visual system | 10.0K | $577.9K | $57.86 | 3.27x |
| 92134 | Imaging of retina | 16.8K | $488.4K | $29.13 | 4.63x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 497 | $434.1K | $873.51 | 4.69x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 2.3K | $268.9K | $114.65 | 2.31x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 1.4K | $225.9K | $157.41 | 1.45x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 198 | $180.7K | $912.84 | 4.82x |
| J3490 | Unclassified drugs | 51 | $92.0K | $1.8K | 1.38x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 1.1K | $77.4K | $71.95 | 3.47x |
| 92250 | Photography of the retina | 1.6K | $58.1K | $35.37 | 4.61x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 110 | $42.6K | $387.25 | 3.91x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 257 | $38.6K | $150.00 | 2.21x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 125 | $30.5K | $243.78 | 8.61x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 418 | $29.5K | $70.47 | 2.41x |
| J7999 | Compounded drug, not otherwise classified | 645 | $25.9K | $40.09 | 2.16x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 35 | $22.5K | $641.44 | 5.46x |
This provider submits charges 2.42 times higher than what Medicare actually pays.
A markup ratio of 2.42x means for every $100 Medicare pays, this provider initially charges $242. 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 IA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Kyle Alliman, M.D. | West Des Moines, IA | $83.3M | ✓ Clear |
| David Saggau, MD | West Des Moines, IA | $73.8M | ✓ Clear |
| Jared Nielsen, M.D., M.S. | West Des Moines, IA | $68.1M | ✓ Clear |
| Alex Kartvelishvili, M.D. | Iowa City, IA | $45.0M | ✓ Clear |
| Michael Wadzinski, M.D. | Sioux City, IA | $37.7M | ✓ 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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