This provider averages 75 services per working day
Based on 186.6K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $30.9M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 75 services per working day raises questions about billing patterns.
68% 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 | $393.96 | $217.29 | 1.81x | $176.67 | $2.5M | 11.4K | 19 |
| 2015 | $449.57 | $222.75 | 2.02x | $226.82 | $2.7M | 12.2K | 22 |
| 2016 | $403.61 | $198.92 | 2.03x | $204.69 | $2.7M | 13.6K | 22 |
| 2017 | $399.37 | $201.74 | 1.98x | $197.63 | $2.9M | 14.2K | 19 |
| 2018 | $407.16 | $204.09 | 2.00x | $203.07 | $3.0M | 14.8K | 20 |
| 2019 | $419.44 | $208.52 | 2.01x | $210.92 | $3.2M | 15.3K | 20 |
| 2020 | $398.88 | $196.61 | 2.03x | $202.27 | $3.5M | 18.0K | 19 |
| 2021 | $404.94 | $204.89 | 1.98x | $200.05 | $3.7M | 17.8K | 21 |
| 2022 | $368.33 | $178.37 | 2.06x | $189.96 | $3.7M | 20.8K | 20 |
| 2023 | $132.42 | $62.64 | 2.11x | $69.78 | $3.0M | 48.4K | 21 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 28.3K | $21.0M | $741.74 | 1.38x |
| 67028 | Injection of drug into eye | 24.8K | $1.9M | $75.23 | 6.04x |
| J2778 | Injection, ranibizumab, 0.1 mg | 6.6K | $1.8M | $278.45 | 1.79x |
| 92014 | Established patient complete exam of visual system | 19.8K | $1.6M | $83.27 | 2.66x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 38.2K | $1.1M | $29.15 | 1.43x |
| 92134 | Imaging of retina | 35.7K | $1.0M | $28.99 | 3.83x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 5.9K | $535.2K | $91.34 | 3.10x |
| J3590 | Unclassified biologics | 7.5K | $470.3K | $62.46 | 4.02x |
| 92250 | Photography of the retina | 6.0K | $206.4K | $34.48 | 4.12x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.9K | $204.2K | $107.64 | 2.58x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 2.2K | $177.0K | $79.32 | 3.11x |
| 92012 | Established patient problem focused exam of visual system | 2.5K | $140.1K | $55.04 | 2.64x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 132 | $115.4K | $874.03 | 3.00x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 123 | $111.0K | $902.15 | 4.68x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1.6K | $85.1K | $53.42 | 2.87x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 228 | $76.3K | $334.77 | 3.58x |
| 92004 | New patient complete exam of visual system | 671 | $65.3K | $97.29 | 3.52x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 177 | $62.4K | $352.46 | 6.81x |
| 76512 | 2d ultrasound scan of eye tissue and structures | 780 | $40.6K | $51.99 | 4.11x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 97 | $37.6K | $387.27 | 4.64x |
This provider submits charges 2.01 times higher than what Medicare actually pays.
A markup ratio of 2.01x means for every $100 Medicare pays, this provider initially charges $201. 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 NE for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| John Welch, MD | Hastings, NE | $94.8M | ✓ Clear |
| William Terrell, M.D. | Hastings, NE | $59.3M | ✓ Clear |
Share this provider's Medicare payment information
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.
Believe this data is inaccurate? Dispute this data