This provider's $5.3M in total Medicare payments ranks in the 96th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 101% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 64% in 2021
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 | $719.76 | $270.75 | 2.66x | $449.01 | $364.5K | 4.8K | 2.9K |
| 2015 | $653.24 | $230.30 | 2.84x | $422.94 | $435.8K | 6.0K | 3.4K |
| 2016 | $758.09 | $243.80 | 3.11x | $514.29 | $487.3K | 6.5K | 3.7K |
| 2017 | $661.11 | $195.73 | 3.38x | $465.38 | $503.7K | 6.9K | 3.7K |
| 2018 | $601.93 | $202.25 | 2.98x | $399.68 | $480.2K | 6.4K | 3.1K |
| 2019 | $726.01 | $236.86 | 3.07x | $489.15 | $518.5K | 5.8K | 2.7K |
| 2020 | $610.32 | $199.85 | 3.05x | $410.47 | $460.3K | 5.1K | 2.5K |
| 2021 | $688.64 | $215.40 | 3.20x | $473.24 | $756.3K | 6.5K | 2.9K |
| 2022 | $679.23 | $209.96 | 3.24x | $469.27 | $532.9K | 6.0K | 3.0K |
| 2023 | $590.71 | $184.00 | 3.21x | $406.71 | $733.1K | 7.7K | 2.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 67028 | Injection of drug into eye | 18.1K | $1.3M | $73.91 | 6.14x |
| J0178 | Injection, aflibercept, 1 mg | 1.6K | $1.2M | $721.63 | 1.37x |
| J3590 | Unclassified biologics | 11.5K | $536.5K | $46.61 | 1.45x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.0K | $305.4K | $76.93 | 2.18x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 213 | $206.3K | $968.63 | 3.07x |
| 92250 | Photography of the retina | 5.2K | $192.8K | $37.00 | 5.31x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 598 | $188.7K | $315.58 | 4.35x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 488 | $183.1K | $375.26 | 4.00x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.6K | $176.8K | $48.96 | 2.21x |
| J9035 | Injection, bevacizumab, 10 mg | 3.3K | $174.0K | $53.01 | 1.89x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.5K | $108.4K | $72.29 | 2.45x |
| 92134 | Diagnostic imaging of retina | 3.5K | $101.8K | $29.13 | 3.43x |
| 67145 | Preventive retinal detachment treatment by heat or laser, 1 or more sessions | 312 | $100.5K | $322.01 | 3.52x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 842 | $95.5K | $113.42 | 2.28x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 1.3K | $91.5K | $70.41 | 3.59x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 54 | $54.2K | $1.0K | 3.39x |
| 99215 | Established patient outpatient visit, total time 40-54 minutes | 439 | $51.8K | $118.05 | 1.69x |
| J7999 | Compounded drug, not otherwise classified | 1.2K | $42.9K | $36.27 | 1.38x |
| 67040 | Laser destruction of eye fluid (vitreous) between the lens and retina | 35 | $34.1K | $973.57 | 2.57x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 1.8K | $32.1K | $17.65 | 2.66x |
This provider submits charges 3.32 times higher than what Medicare actually pays.
A markup ratio of 3.32x means for every $100 Medicare pays, this provider initially charges $332. 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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