This provider's $5.1M in total Medicare payments ranks in the 96th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 6736% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 790% in 2016
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 | $5.0K | $160.17 | 30.99x | $4.8K | $13.1K | 82 | 80 |
| 2015 | $901.48 | $144.44 | 6.24x | $757.04 | $47.4K | 462 | 387 |
| 2016 | $399.12 | $116.35 | 3.43x | $282.77 | $422.2K | 3.9K | 2.1K |
| 2017 | $404.60 | $127.71 | 3.17x | $276.89 | $409.5K | 3.9K | 1.9K |
| 2018 | $607.15 | $244.42 | 2.48x | $362.73 | $117.5K | 1.1K | 639 |
| 2019 | $605.69 | $252.79 | 2.40x | $352.90 | $449.0K | 3.4K | 1.6K |
| 2020 | $559.67 | $233.80 | 2.39x | $325.87 | $759.8K | 5.0K | 2.0K |
| 2021 | $592.18 | $245.22 | 2.41x | $346.96 | $872.9K | 5.3K | 2.0K |
| 2022 | $749.92 | $302.65 | 2.48x | $447.27 | $1.2M | 6.5K | 2.8K |
| 2023 | $555.59 | $216.36 | 2.57x | $339.23 | $893.7K | 7.4K | 2.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 3.3K | $2.4M | $730.90 | 1.77x |
| 67028 | Injection of drug into eye | 8.4K | $713.6K | $85.00 | 4.64x |
| 92134 | Diagnostic imaging of retina | 11.4K | $335.0K | $29.40 | 2.70x |
| J3490 | Unclassified drugs | 158 | $280.3K | $1.8K | 2.42x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 1.6K | $168.3K | $105.36 | 2.16x |
| J9035 | Injection, bevacizumab, 10 mg | 2.5K | $139.3K | $55.91 | 2.15x |
| 67042 | Removal of membrane from the retina, pars plana approach | 165 | $131.8K | $798.67 | 2.87x |
| J2778 | Injection, ranibizumab, 0.1 mg | 470 | $123.6K | $262.88 | 2.00x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 196 | $123.1K | $628.18 | 2.74x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 1.2K | $104.5K | $86.81 | 3.50x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 116 | $94.0K | $810.66 | 4.17x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.4K | $83.1K | $57.99 | 2.06x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 1.3K | $77.6K | $60.26 | 2.39x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 687 | $56.4K | $82.15 | 2.41x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 426 | $49.1K | $115.34 | 2.73x |
| J7999 | Compounded drug, not otherwise classified | 756 | $42.6K | $56.32 | 5.33x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 529 | $39.4K | $74.57 | 4.19x |
| 92250 | Photography of the retina | 785 | $37.5K | $47.78 | 4.60x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 133 | $21.1K | $158.66 | 1.49x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 76 | $19.4K | $255.36 | 3.70x |
This provider submits charges 2.59 times higher than what Medicare actually pays.
A markup ratio of 2.59x means for every $100 Medicare pays, this provider initially charges $259. 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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