This provider averages 99 services per working day
Based on 247.7K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $39.1M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 99 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 169% 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 | $535.86 | $233.67 | 2.29x | $302.19 | $2.6M | 11.3K | 20 |
| 2015 | $577.30 | $252.74 | 2.28x | $324.56 | $2.4M | 9.6K | 19 |
| 2016 | $602.00 | $248.08 | 2.43x | $353.92 | $2.7M | 10.9K | 19 |
| 2017 | $630.73 | $269.45 | 2.34x | $361.28 | $3.6M | 13.3K | 20 |
| 2018 | $546.19 | $218.55 | 2.50x | $327.64 | $2.9M | 13.1K | 20 |
| 2019 | $636.14 | $259.27 | 2.45x | $376.87 | $3.3M | 12.6K | 19 |
| 2020 | $644.63 | $281.22 | 2.29x | $363.41 | $4.1M | 14.5K | 18 |
| 2021 | $673.97 | $291.17 | 2.31x | $382.80 | $4.8M | 16.4K | 20 |
| 2022 | $370.28 | $161.52 | 2.29x | $208.76 | $5.7M | 35.0K | 24 |
| 2023 | $144.66 | $64.32 | 2.25x | $80.34 | $7.1M | 110.9K | 25 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 30.5K | $22.6M | $738.45 | 1.83x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 111.7K | $3.2M | $28.89 | 1.90x |
| J2778 | Injection, ranibizumab, 0.1 mg | 9.7K | $2.7M | $280.35 | 1.85x |
| 67028 | Injection of drug into eye | 23.4K | $2.0M | $87.12 | 7.22x |
| J3590 | Unclassified biologics | 1.5K | $1.8M | $1.2K | 1.82x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 4.5K | $1.1M | $250.01 | 1.56x |
| 92134 | Imaging of retina | 32.1K | $940.5K | $29.26 | 4.15x |
| J3490 | Unclassified drugs | 370 | $641.4K | $1.7K | 1.83x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 4.3K | $520.0K | $120.36 | 1.45x |
| 92012 | Established patient problem focused exam of visual system | 7.8K | $467.7K | $60.29 | 3.03x |
| J7999 | Compounded drug, not otherwise classified | 5.9K | $388.6K | $65.81 | 2.22x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 312 | $282.0K | $903.71 | 5.52x |
| J7313 | Injection, fluocinolone acetonide, intravitreal implant, 0.01 mg | 703 | $270.3K | $384.47 | 1.37x |
| 67113 | Complex repair of detached retina and drainage of eye fluid between lens and retina | 235 | $245.6K | $1.0K | 7.63x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 2.9K | $226.5K | $76.80 | 2.44x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 312 | $215.5K | $690.75 | 5.49x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 2.6K | $201.2K | $77.66 | 3.44x |
| 92014 | Established patient complete exam of visual system | 2.1K | $191.1K | $90.82 | 3.06x |
| 67041 | Removal of membrane of retina | 171 | $154.3K | $902.42 | 5.04x |
| Q5124 | Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg | 894 | $153.2K | $171.35 | 1.59x |
This provider submits charges 2.33 times higher than what Medicare actually pays.
A markup ratio of 2.33x means for every $100 Medicare pays, this provider initially charges $233. 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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