This provider's $12.9M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 312% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 69% in 2022
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 | $230.63 | $89.17 | 2.59x | $141.46 | $812.2K | 9.1K | 18 |
| 2015 | $262.61 | $81.02 | 3.24x | $181.59 | $718.2K | 8.9K | 15 |
| 2016 | $273.64 | $79.67 | 3.43x | $193.97 | $691.4K | 8.7K | 16 |
| 2017 | $275.37 | $78.53 | 3.51x | $196.84 | $702.9K | 9.0K | 15 |
| 2018 | $302.95 | $95.16 | 3.18x | $207.79 | $895.3K | 9.4K | 17 |
| 2019 | $306.87 | $94.12 | 3.26x | $212.75 | $1.2M | 13.3K | 16 |
| 2020 | $314.91 | $95.13 | 3.31x | $219.78 | $1.1M | 11.7K | 15 |
| 2021 | $314.85 | $98.03 | 3.21x | $216.82 | $1.2M | 12.7K | 16 |
| 2022 | $514.76 | $178.97 | 2.88x | $335.79 | $2.1M | 11.7K | 14 |
| 2023 | $1.0K | $234.34 | 4.31x | $776.43 | $3.3M | 14.3K | 17 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 7.8K | $5.6M | $717.08 | 3.02x |
| 67028 | Injection of drug into eye | 18.9K | $1.8M | $94.82 | 4.57x |
| 92014 | Established patient complete exam of visual system | 13.9K | $1.2M | $89.53 | 2.93x |
| J9035 | Injection, bevacizumab, 10 mg | 19.3K | $1.1M | $57.99 | 3.88x |
| 92134 | Imaging of retina | 27.0K | $844.6K | $31.28 | 5.74x |
| 92012 | Established patient problem focused exam of visual system | 9.7K | $623.9K | $64.59 | 3.10x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 2.5K | $537.4K | $216.61 | 2.59x |
| J2778 | Injection, ranibizumab, 0.1 mg | 1.7K | $426.4K | $257.65 | 2.33x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 164 | $153.6K | $936.68 | 2.65x |
| 92004 | New patient complete exam of visual system | 928 | $99.3K | $106.97 | 3.06x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 810 | $97.6K | $120.50 | 3.08x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 880 | $71.5K | $81.21 | 2.78x |
| 92020 | Exam of the internal drainage system of eye | 2.5K | $49.9K | $20.21 | 3.12x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 45 | $43.2K | $960.29 | 3.79x |
| 76512 | 2d ultrasound scan of eye tissue and structures | 765 | $41.4K | $54.07 | 3.60x |
| 92250 | Photography of the retina | 780 | $35.0K | $44.90 | 3.29x |
| J3590 | Unclassified biologics | 110 | $24.2K | $219.65 | 2.55x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 60 | $22.2K | $369.85 | 3.22x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 27 | $19.6K | $725.35 | 3.80x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 18 | $14.2K | $790.92 | 2.02x |
This provider submits charges 3.45 times higher than what Medicare actually pays.
A markup ratio of 3.45x means for every $100 Medicare pays, this provider initially charges $345. 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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