This provider averages 71 services per working day
Based on 177.5K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $27.8M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 71 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 332% from 2014 to 2023.
61% of their billing comes from a single procedure code (J2778 — Injection, ranibizumab, 0.1 mg).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 228% in 2017
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 | $229.27 | $62.92 | 3.64x | $166.35 | $841.6K | 13.4K | 14 |
| 2015 | $242.51 | $65.77 | 3.69x | $176.74 | $871.0K | 13.2K | 15 |
| 2016 | $233.40 | $63.25 | 3.69x | $170.15 | $876.6K | 13.9K | 17 |
| 2017 | $351.28 | $156.75 | 2.24x | $194.53 | $2.9M | 18.4K | 17 |
| 2018 | $429.43 | $193.09 | 2.22x | $236.34 | $4.1M | 21.1K | 12 |
| 2019 | $446.18 | $190.89 | 2.34x | $255.29 | $3.7M | 19.4K | 17 |
| 2020 | $438.21 | $180.57 | 2.43x | $257.64 | $3.9M | 21.4K | 13 |
| 2021 | $434.16 | $170.16 | 2.55x | $264.00 | $3.6M | 21.4K | 18 |
| 2022 | $496.80 | $182.00 | 2.73x | $314.80 | $3.4M | 18.9K | 19 |
| 2023 | $605.22 | $221.00 | 2.74x | $384.22 | $3.6M | 16.4K | 24 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2778 | Injection, ranibizumab, 0.1 mg | 63.4K | $16.8M | $264.69 | 1.85x |
| J0178 | Injection, aflibercept, 1 mg | 4.5K | $3.1M | $696.12 | 2.15x |
| 67028 | Injection of drug into eye | 18.1K | $1.6M | $87.49 | 10.02x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 14.4K | $1.1M | $73.75 | 3.40x |
| 92014 | Established patient complete exam of visual system | 12.4K | $1.0M | $81.08 | 2.26x |
| 92134 | Imaging of retina | 21.5K | $621.9K | $28.92 | 2.94x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 2.8K | $606.7K | $216.13 | 2.31x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 2.7K | $416.7K | $152.25 | 1.94x |
| 92250 | Photography of the retina | 11.5K | $409.9K | $35.62 | 2.39x |
| 92012 | Established patient problem focused exam of visual system | 5.4K | $309.3K | $57.67 | 1.99x |
| J3590 | Unclassified biologics | 5.2K | $273.8K | $52.64 | 1.43x |
| 92004 | New patient complete exam of visual system | 2.4K | $230.8K | $97.56 | 1.72x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 214 | $189.5K | $885.57 | 5.17x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 183 | $169.8K | $928.07 | 7.40x |
| J3490 | Unclassified drugs | 90 | $159.0K | $1.8K | 1.42x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 2.2K | $131.3K | $59.24 | 2.29x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina, complex | 120 | $122.6K | $1.0K | 4.88x |
| 67040 | Destruction of eye fluid (vitreous) between lens and retina and all of retina using a laser | 154 | $117.9K | $765.81 | 7.63x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 720 | $86.7K | $120.36 | 1.45x |
| 92240 | Examination of eye using an endoscope | 489 | $82.6K | $169.02 | 2.96x |
This provider submits charges 2.58 times higher than what Medicare actually pays.
A markup ratio of 2.58x means for every $100 Medicare pays, this provider initially charges $258. 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 SC for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Eric Jablon, M.D. | Charleston, SC | $49.1M | ✓ Clear |
| John Wells, MD | West Columbia, SC | $38.6M | ✓ Clear |
| John Payne, MD | West Columbia, SC | $37.4M | ✓ Clear |
| John Kerrison, M.D. | Charleston, SC | $35.7M | ✓ Clear |
| David Johnson, MD | West Columbia, SC | $34.8M | ✓ 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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