This provider averages 92 services per working day
Based on 230.4K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $56.6M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 92 services per working day raises questions about billing patterns.
71% 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 | $388.13 | $198.85 | 1.95x | $189.28 | $4.3M | 21.5K | 16 |
| 2015 | $435.27 | $225.65 | 1.93x | $209.62 | $4.9M | 21.9K | 18 |
| 2016 | $461.70 | $238.88 | 1.93x | $222.82 | $5.2M | 21.9K | 19 |
| 2017 | $503.13 | $262.75 | 1.91x | $240.38 | $5.5M | 21.0K | 20 |
| 2018 | $527.65 | $282.12 | 1.87x | $245.53 | $6.2M | 21.8K | 16 |
| 2019 | $568.31 | $307.22 | 1.85x | $261.09 | $6.8M | 22.2K | 16 |
| 2020 | $600.76 | $324.64 | 1.85x | $276.12 | $5.9M | 18.0K | 15 |
| 2021 | $609.10 | $330.51 | 1.84x | $278.59 | $6.3M | 19.0K | 15 |
| 2022 | $728.05 | $297.12 | 2.45x | $430.93 | $5.9M | 19.8K | 16 |
| 2023 | $354.93 | $130.34 | 2.72x | $224.59 | $5.6M | 43.2K | 16 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 54.1K | $40.1M | $741.62 | 1.69x |
| J2778 | Injection, ranibizumab, 0.1 mg | 28.3K | $8.2M | $288.60 | 1.63x |
| 67028 | Injection of drug into eye | 37.7K | $3.3M | $86.26 | 5.93x |
| 92134 | Imaging of retina | 43.3K | $1.3M | $29.35 | 4.42x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 30.4K | $884.5K | $29.14 | 2.58x |
| J9035 | Injection, bevacizumab, 10 mg | 12.7K | $713.0K | $56.01 | 1.41x |
| 92012 | Established patient problem focused exam of visual system | 10.5K | $609.8K | $57.90 | 1.74x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 2.4K | $364.8K | $155.09 | 1.40x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 3.4K | $257.2K | $74.74 | 3.78x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 490 | $156.3K | $318.94 | 5.63x |
| J7999 | Compounded drug, not otherwise classified | 1.9K | $129.7K | $68.00 | 1.76x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 330 | $125.4K | $380.13 | 3.68x |
| 92014 | Established patient complete exam of visual system | 1.1K | $94.3K | $89.19 | 2.48x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 251 | $85.4K | $340.37 | 2.92x |
| 92004 | New patient complete exam of visual system | 754 | $78.5K | $104.14 | 1.62x |
| 67040 | Laser destruction of eye fluid (vitreous) between the lens and retina | 55 | $48.9K | $888.65 | 5.06x |
| 67042 | Removal of membrane from the retina, pars plana approach with removal of internal limiting membrane of retina | 53 | $45.8K | $864.20 | 2.31x |
| 92250 | Photography of the retina | 971 | $42.7K | $43.92 | 1.86x |
| J3590 | Unclassified biologics | 17 | $38.2K | $2.2K | 2.55x |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 1.1K | $31.4K | $29.42 | 1.77x |
This provider submits charges 2.03 times higher than what Medicare actually pays.
A markup ratio of 2.03x means for every $100 Medicare pays, this provider initially charges $203. 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 PA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Richard Kaiser, MD | Plymouth Meeting, PA | $75.2M | ✓ Clear |
| Allen Ho, MD | Plymouth Meeting, PA | $67.7M | ✓ Clear |
| Carl Regillo, MD | Plymouth Meeting, PA | $63.5M | ✓ Clear |
| Marc Spirn, MD | Plymouth Meeting, PA | $63.4M | ✓ Clear |
| Mitchell Fineman, MD | Plymouth Meeting, PA | $61.7M | ✓ 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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