This provider averages 82 services per working day
Based on 204.1K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $33.8M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 82 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 119% 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 | $326.01 | $156.62 | 2.08x | $169.39 | $1.9M | 11.9K | 17 |
| 2015 | $328.39 | $165.45 | 1.98x | $162.94 | $2.2M | 13.5K | 18 |
| 2016 | $328.07 | $166.03 | 1.98x | $162.04 | $2.4M | 14.3K | 15 |
| 2017 | $339.20 | $172.75 | 1.96x | $166.45 | $2.8M | 16.3K | 14 |
| 2018 | $338.99 | $185.38 | 1.83x | $153.61 | $3.6M | 19.5K | 13 |
| 2019 | $356.20 | $192.54 | 1.85x | $163.66 | $3.9M | 20.4K | 13 |
| 2020 | $373.71 | $204.46 | 1.83x | $169.25 | $4.2M | 20.4K | 13 |
| 2021 | $417.70 | $211.33 | 1.98x | $206.37 | $4.5M | 21.2K | 15 |
| 2022 | $387.07 | $191.41 | 2.02x | $195.66 | $4.3M | 22.3K | 15 |
| 2023 | $200.08 | $91.94 | 2.18x | $108.14 | $4.1M | 44.5K | 14 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 17.2K | $12.7M | $737.45 | 1.54x |
| J2778 | Injection, ranibizumab, 0.1 mg | 46.1K | $12.1M | $263.00 | 1.65x |
| 92014 | Established patient complete exam of visual system | 30.2K | $2.7M | $91.07 | 3.00x |
| 67028 | Injection of drug into eye | 23.9K | $2.2M | $91.49 | 3.19x |
| 92134 | Imaging of retina | 36.8K | $1.2M | $32.63 | 3.24x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 28.9K | $842.4K | $29.13 | 2.03x |
| J9035 | Injection, bevacizumab, 10 mg | 9.9K | $565.8K | $57.22 | 1.44x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 2.4K | $287.8K | $117.83 | 3.17x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 3.3K | $259.1K | $79.11 | 3.12x |
| 67041 | Removal of membrane of retina | 220 | $208.1K | $946.05 | 3.39x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 2.4K | $194.6K | $80.38 | 3.83x |
| 67042 | Removal of membrane from the retina, pars plana approach with removal of internal limiting membrane of retina | 106 | $104.2K | $982.78 | 3.84x |
| 92250 | Photography of the retina | 1.4K | $66.9K | $47.47 | 3.64x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 69 | $64.2K | $930.82 | 5.35x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 106 | $59.1K | $557.77 | 4.05x |
| J3590 | Unclassified biologics | 29 | $51.3K | $1.8K | 1.27x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 89 | $37.3K | $419.44 | 5.39x |
| 67040 | Laser destruction of eye fluid (vitreous) between the lens and retina | 34 | $31.1K | $914.34 | 7.13x |
| 92012 | Established patient problem focused exam of visual system | 292 | $19.6K | $67.24 | 2.85x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 328 | $17.6K | $53.69 | 2.82x |
This provider submits charges 1.96 times higher than what Medicare actually pays.
A markup ratio of 1.96x means for every $100 Medicare pays, this provider initially charges $196. This is lower 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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