This provider's $3.9M in total Medicare payments ranks in the 95th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 96% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 59% 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 | $373.36 | $100.26 | 3.72x | $273.10 | $344.4K | 3.4K | 2.7K |
| 2015 | $346.78 | $111.09 | 3.12x | $235.69 | $268.1K | 3.6K | 2.8K |
| 2016 | $316.61 | $105.64 | 3.00x | $210.97 | $287.3K | 3.9K | 2.7K |
| 2017 | $346.84 | $105.80 | 3.28x | $241.04 | $271.1K | 3.7K | 2.6K |
| 2018 | $320.08 | $102.61 | 3.12x | $217.47 | $324.3K | 4.3K | 3.0K |
| 2019 | $331.69 | $115.25 | 2.88x | $216.44 | $378.5K | 4.0K | 2.9K |
| 2020 | $276.84 | $99.56 | 2.78x | $177.28 | $321.9K | 3.1K | 2.2K |
| 2021 | $310.13 | $115.46 | 2.69x | $194.67 | $511.0K | 4.0K | 2.3K |
| 2022 | $316.71 | $99.25 | 3.19x | $217.46 | $521.5K | 4.2K | 2.1K |
| 2023 | $317.43 | $102.75 | 3.09x | $214.68 | $675.6K | 4.7K | 1.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 1.7K | $1.2M | $721.73 | 1.55x |
| 66984 | Removal of cataract with insertion of lens | 2.6K | $468.4K | $179.67 | 4.33x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 5.7K | $437.8K | $77.16 | 2.35x |
| 67028 | Injection of drug into eye | 3.9K | $319.7K | $82.48 | 4.63x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 859 | $195.7K | $227.80 | 3.54x |
| 92134 | Diagnostic imaging of retina | 5.5K | $143.2K | $26.02 | 3.35x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.4K | $127.0K | $52.58 | 3.03x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.1K | $118.2K | $105.24 | 2.79x |
| J2778 | Injection, ranibizumab, 0.1 mg | 480 | $111.2K | $231.62 | 2.00x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 1.8K | $97.2K | $55.13 | 2.25x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 905 | $84.8K | $93.71 | 2.48x |
| J9035 | Injection, bevacizumab, 10 mg | 1.4K | $75.3K | $53.91 | 1.78x |
| 92136 | Measurement of corneal curvature and depth of eye | 2.9K | $74.3K | $25.26 | 4.08x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 255 | $47.7K | $186.88 | 5.35x |
| 92083 | Measurement of field of vision during daylight conditions | 1.1K | $41.9K | $36.50 | 3.47x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 544 | $40.7K | $74.88 | 3.25x |
| 92133 | Diagnostic imaging of optic nerve of eye | 1.6K | $33.2K | $20.76 | 3.65x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 378 | $32.8K | $86.85 | 2.32x |
| 0191T | Internal insertion of eye fluid drainage device | 104 | $30.4K | $292.02 | 4.45x |
| 66761 | Creation of eye fluid drainage tracts in iris using laser, per session | 94 | $22.3K | $237.22 | 5.82x |
This provider submits charges 2.81 times higher than what Medicare actually pays.
A markup ratio of 2.81x means for every $100 Medicare pays, this provider initially charges $281. This is higher than the national average.
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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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