This provider averages 94 services per working day
Based on 211.7K total services over 9 years (250 working days/year). Learn about impossible service volumes →
This provider's $44.6M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 94 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 939% from 2015 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 303% in 2016
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 |
|---|---|---|---|---|---|---|---|
| 2015 | $272.37 | $156.57 | 1.74x | $115.80 | $673.7K | 4.3K | 12 |
| 2016 | $316.95 | $180.92 | 1.75x | $136.03 | $2.7M | 15.0K | 18 |
| 2017 | $348.16 | $199.52 | 1.74x | $148.64 | $4.2M | 20.9K | 19 |
| 2018 | $347.97 | $201.10 | 1.73x | $146.87 | $5.6M | 28.0K | 18 |
| 2019 | $348.56 | $194.89 | 1.79x | $153.67 | $6.2M | 31.6K | 16 |
| 2020 | $382.55 | $208.49 | 1.83x | $174.06 | $5.5M | 26.3K | 17 |
| 2021 | $380.89 | $205.20 | 1.86x | $175.69 | $6.4M | 31.2K | 21 |
| 2022 | $453.67 | $238.94 | 1.90x | $214.73 | $6.4M | 26.7K | 19 |
| 2023 | $457.61 | $252.17 | 1.81x | $205.44 | $7.0M | 27.8K | 22 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2778 | Injection, ranibizumab, 0.1 mg | 76.8K | $20.6M | $267.78 | 1.75x |
| J0178 | Injection, aflibercept, 1 mg | 23.2K | $16.6M | $715.79 | 1.51x |
| 67028 | Injection of drug into eye | 21.8K | $2.1M | $98.25 | 3.38x |
| 92014 | Established patient complete exam of visual system | 16.6K | $1.5M | $91.06 | 1.92x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 11.5K | $1.1M | $95.96 | 2.18x |
| 92134 | Imaging of retina | 27.7K | $847.1K | $30.63 | 2.74x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 2.9K | $210.2K | $73.51 | 3.37x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 192 | $177.6K | $924.84 | 2.46x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 8.9K | $169.8K | $19.13 | 2.87x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 1.3K | $145.4K | $108.23 | 1.85x |
| 67113 | Complex repair of detached retina and drainage of eye fluid between lens and retina | 127 | $133.8K | $1.1K | 2.71x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 861 | $128.9K | $149.75 | 1.40x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 4.2K | $122.4K | $29.15 | 1.54x |
| 92250 | Photography of the retina | 3.0K | $117.3K | $39.23 | 3.64x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 266 | $94.4K | $354.80 | 3.94x |
| J3590 | Unclassified biologics | 74 | $68.4K | $924.75 | 1.72x |
| 67141 | Heat or freezing treatment to prevent detachment of retina | 152 | $55.7K | $366.66 | 2.67x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 79 | $54.6K | $691.74 | 2.32x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 195 | $51.3K | $262.91 | 4.85x |
| 92201 | Extended exam of the back part of the eye with retinal drawing | 2.8K | $51.0K | $18.46 | 3.06x |
This provider submits charges 1.81 times higher than what Medicare actually pays.
A markup ratio of 1.81x means for every $100 Medicare pays, this provider initially charges $181. 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 MI for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Scott Sneed, MD | Traverse City, MI | $39.4M | ✓ Clear |
| Jeremy Wolfe, MD | Royal Oak, MI | $39.4M | ✓ Clear |
| Douglas Covert, MD, MPH | Traverse City, MI | $34.7M | ✓ 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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