This provider's $7.8M in total Medicare payments ranks in the 98th percentile of Ophthalmology providers nationally.
Their average markup ratio of 5.22x is significantly above the specialty median of 2.9x.
Medicare payments to this provider grew 187% from 2014 to 2023.
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 | $765.28 | $181.18 | 4.22x | $584.10 | $403.1K | 4.1K | 2.1K |
| 2015 | $761.46 | $172.12 | 4.42x | $589.34 | $491.6K | 4.2K | 2.2K |
| 2016 | $788.97 | $170.25 | 4.63x | $618.72 | $696.6K | 5.6K | 2.8K |
| 2017 | $716.48 | $147.86 | 4.85x | $568.62 | $743.2K | 6.5K | 3.1K |
| 2018 | $1.8K | $206.40 | 8.83x | $1.6K | $836.5K | 7.4K | 3.7K |
| 2019 | $700.44 | $141.84 | 4.94x | $558.60 | $904.6K | 8.3K | 4.0K |
| 2020 | $727.35 | $148.20 | 4.91x | $579.15 | $696.7K | 5.3K | 2.6K |
| 2021 | $767.64 | $163.81 | 4.69x | $603.83 | $928.8K | 6.9K | 3.3K |
| 2022 | $785.12 | $156.83 | 5.01x | $628.29 | $945.9K | 7.5K | 3.5K |
| 2023 | $1.1K | $260.68 | 4.07x | $800.82 | $1.2M | 8.6K | 4.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 4.8K | $3.5M | $737.51 | 2.71x |
| 92250 | Photography of the retina | 15.2K | $728.6K | $47.84 | 5.62x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.2K | $664.2K | $106.55 | 3.52x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 6.2K | $661.0K | $107.44 | 3.30x |
| 67028 | Injection of drug into eye | 5.2K | $591.7K | $113.20 | 25.14x |
| 92134 | Diagnostic imaging of retina | 15.1K | $560.2K | $37.22 | 4.30x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 6.3K | $273.9K | $43.70 | 6.56x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.6K | $228.1K | $142.21 | 3.85x |
| J3590 | Unclassified biologics | 90 | $188.7K | $2.1K | 3.41x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 563 | $81.5K | $144.70 | 3.56x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 530 | $69.0K | $130.13 | 4.73x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 1.2K | $56.2K | $48.03 | 7.18x |
| 76512 | Ultrasound of eye disease, growth, or structure | 747 | $53.6K | $71.81 | 5.12x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 199 | $37.8K | $190.10 | 3.68x |
| 92240 | Examination of eye using an endoscope | 81 | $36.3K | $448.07 | 3.29x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 15 | $17.6K | $1.2K | 15.89x |
| 92242 | Imaging of blood vessels in back of eye using fluorescein and indocyanine-green dye | 76 | $16.7K | $219.52 | 4.19x |
| J2778 | Injection, ranibizumab, 0.1 mg | 35 | $10.9K | $310.99 | 2.57x |
| 92083 | Measurement of field of vision during daylight conditions | 185 | $10.5K | $56.74 | 5.45x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 34 | $2.7K | $79.00 | 3.39x |
This provider submits charges 5.22 times higher than what Medicare actually pays.
A markup ratio of 5.22x means for every $100 Medicare pays, this provider initially charges $522. 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 NY for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Jonathan Jonisch, MD | Great Neck, NY | $52.3M | ✓ Clear |
| Jeffrey Josef, M.D. | Suffern, NY | $52.2M | ✓ Clear |
| Brett Rosenblatt | Great Neck, NY | $50.0M | ✓ Clear |
| Kenneth Graham | Great Neck, NY | $47.1M | ✓ Clear |
| Glenn Stoller, M.D. | Rockville Centre, NY | $46.4M | ✓ 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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