This provider averages 64 services per working day
Based on 159.0K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $34.8M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 64 services per working day raises questions about billing patterns.
64% of their billing comes from a single procedure code (J2778 — Injection, ranibizumab, 0.1 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 | $408.74 | $183.29 | 2.23x | $225.45 | $2.5M | 13.8K | 14 |
| 2015 | $457.27 | $207.40 | 2.20x | $249.87 | $3.5M | 16.7K | 14 |
| 2016 | $472.51 | $213.87 | 2.21x | $258.64 | $3.6M | 16.6K | 17 |
| 2017 | $525.83 | $232.42 | 2.26x | $293.41 | $4.2M | 18.2K | 13 |
| 2018 | $486.90 | $213.63 | 2.28x | $273.27 | $4.0M | 18.7K | 11 |
| 2019 | $470.78 | $196.78 | 2.39x | $274.00 | $4.0M | 20.2K | 11 |
| 2020 | $506.49 | $206.81 | 2.45x | $299.68 | $3.7M | 18.1K | 9 |
| 2021 | $586.22 | $234.47 | 2.50x | $351.75 | $3.4M | 14.6K | 11 |
| 2022 | $668.46 | $252.94 | 2.64x | $415.52 | $2.9M | 11.7K | 10 |
| 2023 | $842.96 | $281.06 | 3.00x | $561.90 | $3.0M | 10.5K | 12 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2778 | Injection, ranibizumab, 0.1 mg | 78.9K | $22.1M | $280.52 | 1.81x |
| J0178 | Injection, aflibercept, 1 mg | 11.4K | $8.2M | $713.59 | 2.08x |
| 67028 | Injection of drug into eye | 18.7K | $1.6M | $83.86 | 11.60x |
| 92134 | Imaging of retina | 28.7K | $832.2K | $29.04 | 2.60x |
| 92014 | Established patient complete exam of visual system | 6.8K | $553.3K | $81.88 | 1.74x |
| 92012 | Established patient problem focused exam of visual system | 8.2K | $480.7K | $58.55 | 1.85x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 2.3K | $257.3K | $113.79 | 2.16x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 944 | $205.4K | $217.58 | 5.95x |
| 67041 | Removal of membrane of retina | 132 | $115.8K | $877.13 | 6.11x |
| 92235 | Imaging of blood vessels in back of eye using fluorescein dye | 1.6K | $115.5K | $72.51 | 3.55x |
| 67210 | Destruction of growth of retina using a laser | 253 | $96.8K | $382.56 | 4.43x |
| J3490 | Unclassified drugs | 46 | $82.9K | $1.8K | 3.75x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 169 | $79.0K | $467.61 | 4.27x |
| 67040 | Laser destruction of eye fluid (vitreous) between the lens and retina | 24 | $21.8K | $909.61 | 6.99x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 15 | $19.5K | $1.3K | 5.35x |
| J3590 | Unclassified biologics | 342 | $18.0K | $52.75 | 1.53x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 167 | $16.9K | $101.06 | 1.49x |
| 76512 | 2d ultrasound scan of eye tissue and structures | 251 | $12.2K | $48.48 | 8.38x |
| 67145 | Preventive retinal detachment treatment by heat or laser, 1 or more sessions | 26 | $10.2K | $391.10 | 3.81x |
| 67515 | Injection of medication or substance into membrane covering eyeball | 32 | $2.3K | $73.16 | 3.06x |
This provider submits charges 2.4 times higher than what Medicare actually pays.
A markup ratio of 2.4x means for every $100 Medicare pays, this provider initially charges $240. 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 SC for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Eric Jablon, M.D. | Charleston, SC | $49.1M | ✓ Clear |
| John Wells, MD | West Columbia, SC | $38.6M | ✓ Clear |
| John Payne, MD | West Columbia, SC | $37.4M | ✓ Clear |
| John Kerrison, M.D. | Charleston, SC | $35.7M | ✓ 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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