This provider averages 63 services per working day
Based on 158.6K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $24.2M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 63 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 121% 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 | $266.87 | $142.99 | 1.87x | $123.88 | $1.7M | 11.7K | 21 |
| 2015 | $267.22 | $138.31 | 1.93x | $128.91 | $1.7M | 12.2K | 24 |
| 2016 | $276.99 | $139.64 | 1.98x | $137.35 | $1.9M | 13.6K | 25 |
| 2017 | $313.18 | $158.62 | 1.97x | $154.56 | $2.1M | 13.3K | 20 |
| 2018 | $306.03 | $153.84 | 1.99x | $152.19 | $2.4M | 15.8K | 22 |
| 2019 | $310.77 | $149.66 | 2.08x | $161.11 | $2.4M | 16.0K | 24 |
| 2020 | $358.80 | $169.20 | 2.12x | $189.60 | $2.7M | 16.2K | 22 |
| 2021 | $419.55 | $208.46 | 2.01x | $211.09 | $2.8M | 13.4K | 14 |
| 2022 | $360.31 | $177.34 | 2.03x | $182.97 | $2.7M | 15.4K | 20 |
| 2023 | $245.82 | $119.91 | 2.05x | $125.91 | $3.7M | 31.0K | 17 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 17.7K | $13.0M | $734.28 | 1.62x |
| J2778 | Injection, ranibizumab, 0.1 mg | 9.6K | $2.7M | $284.10 | 1.87x |
| 67028 | Injection of drug into eye | 27.2K | $2.5M | $92.89 | 3.77x |
| J9035 | Injection, bevacizumab, 10 mg | 22.9K | $1.3M | $55.38 | 1.98x |
| 92134 | Imaging of retina | 32.7K | $1.1M | $33.47 | 2.28x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 20.7K | $602.1K | $29.09 | 1.55x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 3.7K | $337.1K | $90.47 | 2.23x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 3.4K | $312.2K | $92.39 | 1.89x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 5.4K | $287.9K | $52.95 | 2.39x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 224 | $211.7K | $945.09 | 2.69x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 182 | $183.0K | $1.0K | 2.42x |
| J3490 | Unclassified drugs | 76 | $179.8K | $2.4K | 4.13x |
| 67041 | Removal of membrane of retina | 190 | $179.2K | $943.09 | 2.36x |
| J7999 | Compounded drug, not otherwise classified | 2.1K | $168.7K | $79.06 | 2.32x |
| 67210 | Destruction of growth of retina using a laser | 343 | $136.9K | $399.11 | 2.20x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 196 | $136.7K | $697.69 | 2.35x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 1.7K | $134.6K | $78.76 | 2.31x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 1.9K | $120.8K | $63.32 | 2.08x |
| 92250 | Photography of the retina | 2.1K | $101.7K | $48.93 | 2.58x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 214 | $79.0K | $369.22 | 2.39x |
This provider submits charges 2.02 times higher than what Medicare actually pays.
A markup ratio of 2.02x means for every $100 Medicare pays, this provider initially charges $202. 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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