This provider averages 75 services per working day
Based on 187.0K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $42.0M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 75 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 62% from 2014 to 2023.
67% 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 | $341.81 | $137.63 | 2.48x | $204.18 | $2.9M | 21.1K | 21 |
| 2015 | $370.42 | $148.23 | 2.50x | $222.19 | $2.9M | 19.3K | 22 |
| 2016 | $408.79 | $153.64 | 2.66x | $255.15 | $3.2M | 21.0K | 21 |
| 2017 | $531.12 | $197.01 | 2.70x | $334.11 | $3.5M | 17.7K | 19 |
| 2018 | $599.92 | $232.36 | 2.58x | $367.56 | $3.7M | 16.1K | 17 |
| 2019 | $637.81 | $251.91 | 2.53x | $385.90 | $4.6M | 18.2K | 20 |
| 2020 | $754.02 | $302.23 | 2.49x | $451.79 | $5.9M | 19.4K | 20 |
| 2021 | $823.71 | $329.08 | 2.50x | $494.63 | $5.9M | 17.9K | 20 |
| 2022 | $831.39 | $318.98 | 2.61x | $512.41 | $4.7M | 14.7K | 18 |
| 2023 | $586.03 | $218.59 | 2.68x | $367.44 | $4.7M | 21.6K | 18 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 38.2K | $28.1M | $735.34 | 2.13x |
| J2778 | Injection, ranibizumab, 0.1 mg | 20.8K | $5.7M | $276.26 | 1.90x |
| 67028 | Injection of drug into eye | 27.9K | $2.4M | $85.58 | 7.62x |
| 92134 | Imaging of retina | 39.6K | $1.2M | $31.31 | 5.74x |
| 92014 | Established patient complete exam of visual system | 12.5K | $1.1M | $88.01 | 1.98x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 6.8K | $499.9K | $73.82 | 3.19x |
| 92012 | Established patient problem focused exam of visual system | 7.0K | $431.8K | $62.11 | 2.17x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 866 | $386.6K | $446.37 | 5.07x |
| J3590 | Unclassified biologics | 6.4K | $343.5K | $53.34 | 1.36x |
| 92240 | Examination of eye using an endoscope | 1.8K | $303.2K | $172.39 | 1.60x |
| 67210 | Destruction of growth of retina using a laser | 580 | $233.6K | $402.69 | 4.18x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 7.1K | $205.1K | $28.96 | 2.38x |
| J9035 | Injection, bevacizumab, 10 mg | 3.1K | $177.6K | $57.37 | 4.18x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.3K | $150.9K | $116.46 | 1.89x |
| 92242 | Exam of retinal blood vessels and blood vessels between the white part of eye and retina using a special camera after injection of a dye | 809 | $142.7K | $176.43 | 1.70x |
| 92004 | New patient complete exam of visual system | 1.2K | $126.2K | $104.40 | 2.01x |
| 92250 | Photography of the retina | 2.5K | $102.6K | $41.23 | 1.94x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 3.2K | $65.7K | $20.62 | 3.39x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 887 | $59.7K | $67.31 | 2.30x |
| 76512 | 2d ultrasound scan of eye tissue and structures | 675 | $35.7K | $52.90 | 5.72x |
This provider submits charges 2.57 times higher than what Medicare actually pays.
A markup ratio of 2.57x means for every $100 Medicare pays, this provider initially charges $257. 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 NC for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Shil Patel, M.D. | New Bern, NC | $63.1M | ✓ Clear |
| James Pate, M.D. | Raleigh, NC | $44.5M | ✓ Clear |
| Justin Brown, M.D. | Charlotte, NC | $43.5M | ✓ Clear |
| Igor Westra, MD | Wilmington, NC | $40.5M | ✓ Clear |
| William Bridges, M.D. | Asheville, NC | $38.4M | ✓ 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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