This provider's $4.4M in total Medicare payments ranks in the 96th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 72% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 55% in 2015
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 | $436.06 | $162.74 | 2.68x | $273.32 | $332.1K | 4.1K | 2.3K |
| 2015 | $561.45 | $199.82 | 2.81x | $361.63 | $513.5K | 4.7K | 2.5K |
| 2016 | $341.36 | $135.31 | 2.52x | $206.05 | $599.2K | 5.6K | 2.6K |
| 2017 | $516.12 | $192.51 | 2.68x | $323.61 | $470.6K | 5.2K | 2.1K |
| 2018 | $468.17 | $150.15 | 3.12x | $318.02 | $346.4K | 4.8K | 2.1K |
| 2019 | $447.75 | $141.44 | 3.17x | $306.31 | $334.6K | 4.3K | 1.8K |
| 2020 | $551.00 | $163.62 | 3.37x | $387.38 | $320.4K | 4.1K | 1.8K |
| 2021 | $643.86 | $186.97 | 3.44x | $456.89 | $397.1K | 4.7K | 2.3K |
| 2022 | $951.91 | $270.93 | 3.51x | $680.98 | $487.3K | 5.6K | 2.7K |
| 2023 | $406.19 | $132.81 | 3.06x | $273.38 | $570.9K | 5.7K | 2.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 1.2K | $917.9K | $745.07 | 1.45x |
| 67028 | Injection of drug into eye | 10.0K | $883.2K | $88.33 | 7.61x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 6.0K | $550.0K | $92.11 | 2.03x |
| J9035 | Injection, bevacizumab, 10 mg | 6.6K | $375.6K | $56.92 | 1.76x |
| J2778 | Injection, ranibizumab, 0.1 mg | 1.4K | $358.5K | $260.19 | 1.65x |
| 92134 | Diagnostic imaging of retina | 9.3K | $303.9K | $32.58 | 4.60x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.6K | $242.9K | $92.84 | 2.01x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.1K | $131.3K | $120.54 | 2.10x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 2.0K | $129.6K | $63.79 | 1.98x |
| 67041 | Removal of membrane from the retina | 98 | $91.3K | $931.17 | 3.76x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.3K | $85.3K | $64.97 | 1.86x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 3.5K | $68.9K | $19.72 | 3.05x |
| 92250 | Photography of the retina | 1.7K | $49.0K | $28.74 | 4.87x |
| 67145 | Preventive retinal detachment treatment by heat or laser, 1 or more sessions | 127 | $40.8K | $321.46 | 4.90x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 252 | $22.1K | $87.77 | 2.95x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 179 | $20.3K | $113.21 | 2.22x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 25 | $17.6K | $705.47 | 3.69x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 541 | $15.6K | $28.91 | 1.51x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 18 | $14.6K | $812.87 | 2.95x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 35 | $14.5K | $415.29 | 3.85x |
This provider submits charges 3.3 times higher than what Medicare actually pays.
A markup ratio of 3.3x means for every $100 Medicare pays, this provider initially charges $330. 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.
Share this provider's Medicare payment information
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.
Believe this data is inaccurate? Dispute this data