This provider averages 63 services per working day
Based on 156.6K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $32.0M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 63 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 446% from 2014 to 2023.
73% 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 253% in 2015
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 | $232.98 | $118.80 | 1.96x | $114.18 | $723.6K | 6.1K | 13 |
| 2015 | $528.26 | $232.33 | 2.27x | $295.93 | $2.6M | 11.0K | 16 |
| 2016 | $455.11 | $245.17 | 1.86x | $209.94 | $2.4M | 9.7K | 12 |
| 2017 | $508.60 | $281.78 | 1.80x | $226.82 | $3.2M | 11.3K | 16 |
| 2018 | $570.99 | $290.42 | 1.97x | $280.57 | $3.4M | 11.7K | 17 |
| 2019 | $522.40 | $283.04 | 1.85x | $239.36 | $3.9M | 13.8K | 16 |
| 2020 | $525.20 | $285.59 | 1.84x | $239.61 | $4.0M | 14.0K | 13 |
| 2021 | $540.95 | $288.91 | 1.87x | $252.04 | $4.4M | 15.2K | 11 |
| 2022 | $390.77 | $203.99 | 1.92x | $186.78 | $3.5M | 17.4K | 12 |
| 2023 | $165.02 | $84.99 | 1.94x | $80.03 | $3.9M | 46.5K | 13 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 31.6K | $23.4M | $741.19 | 1.70x |
| J2778 | Injection, ranibizumab, 0.1 mg | 12.5K | $3.2M | $256.25 | 1.98x |
| 67028 | Injection of drug into eye | 19.5K | $1.6M | $83.69 | 3.74x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 39.3K | $1.1M | $28.99 | 1.72x |
| 92134 | Imaging of retina | 29.8K | $843.4K | $28.33 | 2.92x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 6.3K | $338.5K | $53.83 | 2.81x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 3.6K | $299.8K | $82.95 | 2.24x |
| J3590 | Unclassified biologics | 4.0K | $279.6K | $70.05 | 2.93x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 3.2K | $270.2K | $84.08 | 2.59x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.5K | $171.8K | $113.31 | 2.55x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 2.2K | $117.3K | $53.02 | 2.65x |
| J3490 | Unclassified drugs | 47 | $82.6K | $1.8K | 1.46x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 631 | $75.9K | $120.36 | 1.37x |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 766 | $56.0K | $73.08 | 2.84x |
| 92250 | Photography of the retina | 857 | $29.2K | $34.10 | 2.74x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 78 | $19.4K | $248.99 | 1.67x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 176 | $18.9K | $107.34 | 2.50x |
| 92235 | Imaging of blood vessels in back of eye using fluorescein dye | 179 | $15.0K | $83.58 | 2.60x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 30 | $8.9K | $297.94 | 2.61x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 40 | $5.8K | $145.44 | 2.36x |
This provider submits charges 1.91 times higher than what Medicare actually pays.
A markup ratio of 1.91x means for every $100 Medicare pays, this provider initially charges $191. 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 KY for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Inder Singal, MD | Louisville, KY | $35.2M | ✓ 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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