This provider's $8.7M in total Medicare payments ranks in the 98th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 135% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 58% in 2019
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 | $338.48 | $155.25 | 2.18x | $183.23 | $407.1K | 5.4K | 2.1K |
| 2015 | $648.83 | $255.90 | 2.54x | $392.93 | $567.0K | 6.2K | 2.4K |
| 2016 | $455.26 | $171.55 | 2.65x | $283.71 | $580.8K | 6.4K | 2.3K |
| 2017 | $552.92 | $181.82 | 3.04x | $371.10 | $680.5K | 7.1K | 2.5K |
| 2018 | $496.15 | $169.45 | 2.93x | $326.70 | $787.0K | 7.8K | 2.6K |
| 2019 | $610.12 | $231.64 | 2.63x | $378.48 | $1.2M | 12.0K | 4.0K |
| 2020 | $546.15 | $208.08 | 2.62x | $338.07 | $1.2M | 10.8K | 3.7K |
| 2021 | $330.25 | $120.82 | 2.73x | $209.43 | $1.2M | 11.2K | 3.6K |
| 2022 | $664.04 | $198.17 | 3.35x | $465.87 | $1.2M | 9.7K | 3.6K |
| 2023 | $613.00 | $141.94 | 4.32x | $471.06 | $957.9K | 6.9K | 2.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 4.9K | $3.6M | $732.08 | 2.41x |
| 67028 | Injection of drug into eye | 17.2K | $1.6M | $93.70 | 4.50x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 16.1K | $1.1M | $66.39 | 2.78x |
| J9035 | Injection, bevacizumab, 10 mg | 12.3K | $713.0K | $57.84 | 3.87x |
| 92134 | Diagnostic imaging of retina | 23.0K | $712.9K | $31.03 | 5.74x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 3.8K | $284.6K | $74.75 | 3.95x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 1.6K | $175.0K | $108.62 | 2.90x |
| J2778 | Injection, ranibizumab, 0.1 mg | 390 | $92.5K | $237.19 | 2.43x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 348 | $75.8K | $217.84 | 2.57x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 537 | $65.1K | $121.15 | 3.08x |
| 67042 | Removal of membrane from the retina, pars plana approach | 63 | $57.7K | $915.44 | 2.83x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 134 | $54.3K | $405.13 | 2.51x |
| 92250 | Photography of the retina | 1.0K | $46.1K | $44.20 | 3.33x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 567 | $44.6K | $78.68 | 2.76x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 91 | $43.6K | $479.29 | 3.88x |
| 67041 | Removal of membrane from the retina | 44 | $39.2K | $891.89 | 2.60x |
| 76512 | Ultrasound of eye disease, growth, or structure | 282 | $16.8K | $59.52 | 3.33x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 11 | $13.8K | $1.3K | 2.51x |
| 67145 | Preventive retinal detachment treatment by heat or laser, 1 or more sessions | 25 | $10.3K | $411.30 | 2.59x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 478 | $10.1K | $21.10 | 4.50x |
This provider submits charges 3.33 times higher than what Medicare actually pays.
A markup ratio of 3.33x means for every $100 Medicare pays, this provider initially charges $333. 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 MN for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| David Williams, MD | Edina, MN | $42.6M | ✓ Clear |
| Sundeep Dev, MD | Minneapolis, MN | $34.6M | ✓ 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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