This provider averages 98 services per working day
Based on 245.0K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $37.7M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 98 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 102% from 2014 to 2023.
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 | $201.25 | $135.83 | 1.48x | $65.42 | $2.4M | 17.3K | 23 |
| 2015 | $221.98 | $155.21 | 1.43x | $66.77 | $2.8M | 18.3K | 22 |
| 2016 | $237.24 | $166.91 | 1.42x | $70.33 | $3.3M | 19.9K | 24 |
| 2017 | $233.64 | $169.70 | 1.38x | $63.94 | $3.7M | 21.6K | 27 |
| 2018 | $276.14 | $201.03 | 1.37x | $75.11 | $4.1M | 20.2K | 26 |
| 2019 | $335.42 | $214.64 | 1.56x | $120.78 | $4.6M | 21.2K | 24 |
| 2020 | $379.87 | $215.89 | 1.76x | $163.98 | $4.0M | 18.5K | 25 |
| 2021 | $414.46 | $231.93 | 1.79x | $182.53 | $4.2M | 17.9K | 22 |
| 2022 | $371.62 | $201.41 | 1.85x | $170.21 | $4.0M | 20.0K | 20 |
| 2023 | $117.76 | $68.02 | 1.73x | $49.74 | $4.8M | 70.1K | 18 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 25.3K | $18.7M | $737.79 | 1.44x |
| J2778 | Injection, ranibizumab, 0.1 mg | 31.6K | $8.9M | $281.61 | 1.51x |
| 67028 | Injection of drug into eye | 34.4K | $2.8M | $81.33 | 2.40x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 59.6K | $1.7M | $29.00 | 1.38x |
| 92134 | Imaging of retina | 42.6K | $1.3M | $29.54 | 2.32x |
| J3590 | Unclassified biologics | 13.9K | $966.9K | $69.56 | 1.62x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 3.6K | $562.9K | $156.13 | 1.43x |
| 92012 | Established patient problem focused exam of visual system | 8.9K | $502.0K | $56.50 | 2.14x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 1.6K | $380.5K | $243.31 | 1.40x |
| 92004 | New patient complete exam of visual system | 2.5K | $256.4K | $100.74 | 2.18x |
| Q5124 | Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg | 1.5K | $252.8K | $172.45 | 1.46x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 559 | $200.6K | $358.92 | 2.24x |
| 92014 | Established patient complete exam of visual system | 2.4K | $186.1K | $77.82 | 2.17x |
| J7999 | Compounded drug, not otherwise classified | 3.3K | $173.8K | $53.26 | 1.54x |
| J7313 | Injection, fluocinolone acetonide, intravitreal implant, 0.01 mg | 361 | $133.5K | $369.87 | 1.36x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 366 | $124.2K | $339.46 | 1.93x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.1K | $121.8K | $114.59 | 1.84x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 974 | $83.0K | $85.21 | 1.88x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 90 | $79.6K | $884.14 | 2.17x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 90 | $79.1K | $878.39 | 2.79x |
This provider submits charges 1.59 times higher than what Medicare actually pays.
A markup ratio of 1.59x means for every $100 Medicare pays, this provider initially charges $159. 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 IA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Kyle Alliman, M.D. | West Des Moines, IA | $83.3M | ✓ Clear |
| David Saggau, MD | West Des Moines, IA | $73.8M | ✓ Clear |
| Jared Nielsen, M.D., M.S. | West Des Moines, IA | $68.1M | ✓ Clear |
| Alex Kartvelishvili, M.D. | Iowa City, IA | $45.0M | ✓ 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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