This provider averages 54 services per working day
Based on 135.2K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $27.2M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 54 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 171% from 2014 to 2023.
69% 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 | $294.93 | $180.78 | 1.63x | $114.15 | $1.6M | 8.6K | 19 |
| 2015 | $286.18 | $171.67 | 1.67x | $114.51 | $1.5M | 8.7K | 20 |
| 2016 | $265.39 | $180.40 | 1.47x | $84.99 | $1.8M | 9.8K | 19 |
| 2017 | $257.16 | $189.00 | 1.36x | $68.16 | $2.1M | 11.2K | 21 |
| 2018 | $243.63 | $179.54 | 1.36x | $64.09 | $2.3M | 12.6K | 15 |
| 2019 | $263.43 | $200.08 | 1.32x | $63.35 | $2.9M | 14.4K | 17 |
| 2020 | $305.34 | $231.13 | 1.32x | $74.21 | $2.9M | 12.4K | 17 |
| 2021 | $314.36 | $242.50 | 1.30x | $71.86 | $3.7M | 15.4K | 17 |
| 2022 | $332.99 | $248.17 | 1.34x | $84.82 | $4.3M | 17.2K | 16 |
| 2023 | $237.90 | $169.34 | 1.40x | $68.56 | $4.2M | 24.9K | 16 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 25.6K | $18.8M | $735.06 | 1.29x |
| J2778 | Injection, ranibizumab, 0.1 mg | 9.5K | $2.7M | $280.01 | 1.35x |
| 67028 | Injection of drug into eye | 15.7K | $1.5M | $94.02 | 2.10x |
| 92134 | Imaging of retina | 27.7K | $888.1K | $32.05 | 1.56x |
| 92014 | Established patient complete exam of visual system | 10.0K | $863.6K | $86.63 | 1.62x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 8.0K | $485.9K | $60.83 | 1.58x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 4.3K | $370.1K | $85.34 | 1.75x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 2.4K | $310.8K | $128.90 | 1.60x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 8.6K | $248.7K | $28.98 | 1.34x |
| J9035 | Injection, bevacizumab, 10 mg | 2.7K | $160.5K | $58.97 | 1.43x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 2.0K | $157.0K | $77.12 | 1.94x |
| 92004 | New patient complete exam of visual system | 911 | $104.1K | $114.24 | 1.45x |
| 92201 | Extended exam of the back part of the eye with retinal drawing | 4.8K | $91.4K | $18.94 | 1.39x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 4.6K | $89.4K | $19.31 | 1.48x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 220 | $86.2K | $391.73 | 1.44x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 3.5K | $75.8K | $21.73 | 1.57x |
| 92250 | Photography of the retina | 1.5K | $69.3K | $45.34 | 1.67x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 90 | $51.0K | $566.75 | 2.08x |
| 67042 | Removal of membrane from the retina, pars plana approach | 49 | $47.6K | $971.67 | 1.82x |
| 76512 | 2d ultrasound scan of eye tissue and structures | 817 | $41.9K | $51.25 | 1.53x |
This provider submits charges 1.39 times higher than what Medicare actually pays.
A markup ratio of 1.39x means for every $100 Medicare pays, this provider initially charges $139. 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 IL for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Sohail Hasan, MD | Harvey, IL | $37.2M | ✓ Clear |
| Michael Mcclintock, M.D. | Chicago, IL | $34.3M | ✓ 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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