This provider averages 70 services per working day
Based on 175.9K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $20.9M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 70 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 2269% from 2014 to 2023.
63% of their billing comes from a single procedure code (J0178 — Injection, aflibercept, 1 mg).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 319% 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 | $265.18 | $79.33 | 3.34x | $185.85 | $277.7K | 3.5K | 14 |
| 2015 | $300.38 | $97.68 | 3.08x | $202.70 | $505.1K | 5.2K | 13 |
| 2016 | $391.34 | $152.62 | 2.56x | $238.72 | $980.1K | 6.4K | 16 |
| 2017 | $387.92 | $163.40 | 2.37x | $224.52 | $344.0K | 2.1K | 9 |
| 2018 | $561.49 | $172.86 | 3.25x | $388.63 | $183.2K | 1.1K | 10 |
| 2019 | $538.53 | $183.78 | 2.93x | $354.75 | $768.4K | 4.2K | 15 |
| 2020 | $520.17 | $206.29 | 2.52x | $313.88 | $2.3M | 10.9K | 20 |
| 2021 | $583.15 | $246.74 | 2.36x | $336.41 | $3.6M | 14.7K | 17 |
| 2022 | $573.70 | $236.69 | 2.42x | $337.01 | $5.3M | 22.6K | 18 |
| 2023 | $154.23 | $62.52 | 2.47x | $91.71 | $6.6M | 105.2K | 19 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 17.9K | $13.0M | $724.76 | 2.05x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 88.8K | $2.6M | $29.09 | 2.06x |
| 67028 | Injection of drug into eye | 16.1K | $1.3M | $82.93 | 4.52x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 11.7K | $1.0M | $85.37 | 2.90x |
| J2778 | Injection, ranibizumab, 0.1 mg | 3.7K | $716.9K | $193.80 | 4.11x |
| 92134 | Imaging of retina | 19.9K | $583.7K | $29.39 | 4.96x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 864 | $215.2K | $249.05 | 2.01x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.9K | $213.8K | $115.34 | 2.12x |
| J9035 | Injection, bevacizumab, 10 mg | 3.1K | $182.8K | $58.19 | 6.00x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 2.4K | $139.0K | $58.68 | 1.76x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 160 | $137.1K | $856.67 | 3.64x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 1.6K | $132.9K | $81.12 | 3.68x |
| J3590 | Unclassified biologics | 2.7K | $102.6K | $38.33 | 1.81x |
| 67210 | Destruction of growth of retina using a laser | 187 | $70.8K | $378.41 | 3.91x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 923 | $61.3K | $66.39 | 1.87x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 638 | $56.5K | $88.63 | 2.16x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 84 | $54.0K | $642.56 | 4.53x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 315 | $49.9K | $158.49 | 2.51x |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 504 | $38.1K | $75.51 | 2.19x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 36 | $34.2K | $949.39 | 6.42x |
This provider submits charges 2.5 times higher than what Medicare actually pays.
A markup ratio of 2.5x means for every $100 Medicare pays, this provider initially charges $250. 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 IN for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Drew Sommerville, MD | Evansville, IN | $35.4M | ✓ 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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