This provider's $8.7M in total Medicare payments ranks in the 98th percentile of Ophthalmology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $459.95 | $185.91 | 2.47x | $274.04 | $597.6K | 7.4K | 2.7K |
| 2015 | $448.02 | $181.84 | 2.46x | $266.18 | $728.5K | 7.9K | 2.9K |
| 2016 | $340.69 | $140.38 | 2.43x | $200.31 | $772.5K | 8.2K | 3.1K |
| 2017 | $393.05 | $118.88 | 3.31x | $274.17 | $861.0K | 8.5K | 3.1K |
| 2018 | $406.49 | $129.32 | 3.14x | $277.17 | $971.6K | 8.9K | 3.1K |
| 2019 | $403.15 | $135.82 | 2.97x | $267.33 | $1.1M | 9.6K | 3.3K |
| 2020 | $507.37 | $149.59 | 3.39x | $357.78 | $955.7K | 7.4K | 2.6K |
| 2021 | $573.15 | $180.95 | 3.17x | $392.20 | $985.3K | 6.6K | 1.9K |
| 2022 | $472.66 | $120.07 | 3.94x | $352.59 | $939.1K | 6.9K | 2.0K |
| 2023 | $419.16 | $135.55 | 3.09x | $283.61 | $700.5K | 6.8K | 1.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 5.5K | $4.1M | $738.74 | 1.71x |
| 67028 | Injection of drug into eye | 17.7K | $1.4M | $81.25 | 5.64x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 13.3K | $1.1M | $84.19 | 2.87x |
| 92134 | Diagnostic imaging of retina | 24.2K | $752.3K | $31.05 | 4.38x |
| J7999 | Compounded drug, not otherwise classified | 7.8K | $486.9K | $62.45 | 4.28x |
| J2778 | Injection, ranibizumab, 0.1 mg | 540 | $163.2K | $302.26 | 1.97x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 1.4K | $103.9K | $74.50 | 3.62x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 1.6K | $91.2K | $57.39 | 2.26x |
| J9035 | Injection, bevacizumab, 10 mg | 1.4K | $70.4K | $51.15 | 2.26x |
| 92250 | Photography of the retina | 1.4K | $56.1K | $41.12 | 3.33x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 136 | $53.0K | $389.99 | 5.15x |
| J3590 | Unclassified biologics | 996 | $51.3K | $51.50 | 1.55x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 479 | $45.5K | $94.92 | 2.78x |
| 66984 | Removal of cataract with insertion of lens | 60 | $29.2K | $486.80 | 2.83x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 173 | $27.0K | $156.33 | 2.48x |
| 67145 | Preventive retinal detachment treatment by heat or laser, 1 or more sessions | 54 | $18.6K | $344.92 | 3.82x |
| Q9977 | Compounded Drug, Not Otherwise Classified | 334 | $18.2K | $54.57 | 1.84x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 541 | $15.8K | $29.19 | 2.02x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 20 | $8.1K | $403.93 | 3.07x |
| 92083 | Measurement of field of vision during daylight conditions | 146 | $6.4K | $43.96 | 3.99x |
This provider submits charges 2.98 times higher than what Medicare actually pays.
A markup ratio of 2.98x means for every $100 Medicare pays, this provider initially charges $298. 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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