This provider's $26.8M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 60% from 2014 to 2023.
83% 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 | $361.09 | $262.44 | 1.38x | $98.65 | $2.0M | 7.8K | 17 |
| 2015 | $384.37 | $290.03 | 1.33x | $94.34 | $2.4M | 8.1K | 15 |
| 2016 | $361.96 | $270.84 | 1.34x | $91.12 | $2.4M | 8.9K | 14 |
| 2017 | $363.42 | $273.33 | 1.33x | $90.09 | $2.0M | 7.2K | 12 |
| 2018 | $337.54 | $251.64 | 1.34x | $85.90 | $2.4M | 9.4K | 15 |
| 2019 | $349.42 | $263.13 | 1.33x | $86.29 | $2.7M | 10.1K | 15 |
| 2020 | $412.16 | $296.72 | 1.39x | $115.44 | $3.0M | 10.2K | 14 |
| 2021 | $424.03 | $304.06 | 1.39x | $119.97 | $3.4M | 11.3K | 13 |
| 2022 | $397.09 | $289.83 | 1.37x | $107.26 | $3.3M | 11.4K | 15 |
| 2023 | $388.28 | $287.29 | 1.35x | $100.99 | $3.3M | 11.4K | 16 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 30.0K | $22.2M | $740.49 | 1.31x |
| 67028 | Injection of drug into eye | 16.1K | $1.5M | $92.76 | 1.83x |
| 92134 | Imaging of retina | 22.5K | $746.2K | $33.18 | 1.51x |
| 92012 | Established patient problem focused exam of visual system | 8.3K | $524.7K | $63.21 | 1.51x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 2.3K | $367.4K | $157.63 | 1.28x |
| J9035 | Injection, bevacizumab, 10 mg | 4.8K | $267.8K | $56.33 | 1.40x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 2.0K | $245.0K | $123.69 | 1.44x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 3.5K | $187.5K | $53.06 | 1.54x |
| J2778 | Injection, ranibizumab, 0.1 mg | 464 | $137.2K | $295.63 | 1.49x |
| 92250 | Photography of the retina | 2.3K | $107.8K | $47.61 | 1.54x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 1.1K | $95.1K | $85.00 | 1.46x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 71 | $67.4K | $949.47 | 1.41x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 81 | $53.4K | $659.65 | 1.58x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 47 | $53.2K | $1.1K | 2.04x |
| 92014 | Established patient complete exam of visual system | 608 | $51.5K | $84.67 | 1.56x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 82 | $38.5K | $469.07 | 1.63x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 95 | $33.0K | $346.93 | 1.87x |
| 76512 | 2d ultrasound scan of eye tissue and structures | 474 | $27.4K | $57.72 | 1.54x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 26 | $23.3K | $895.10 | 1.58x |
| 67107 | Repair of detached retina and drainage of eye fluid between lens and retina | 13 | $12.6K | $969.98 | 1.35x |
This provider submits charges 1.36 times higher than what Medicare actually pays.
A markup ratio of 1.36x means for every $100 Medicare pays, this provider initially charges $136. 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 |
|---|---|---|---|
| Sohail Hasan, MD | Harvey, IL | $37.2M | ✓ Clear |
| 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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