This provider's $15.9M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 5224% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 758% 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 | $122.65 | $75.01 | 1.64x | $47.64 | $64.4K | 858 | 1 |
| 2015 | $121.74 | $71.89 | 1.69x | $49.85 | $58.7K | 816 | 3 |
| 2016 | $247.61 | $147.26 | 1.68x | $100.35 | $503.0K | 3.4K | 19 |
| 2017 | $240.55 | $139.23 | 1.73x | $101.32 | $1.3M | 9.2K | 25 |
| 2018 | $240.24 | $134.84 | 1.78x | $105.40 | $1.5M | 11.5K | 24 |
| 2019 | $334.73 | $140.27 | 2.39x | $194.46 | $1.9M | 13.6K | 23 |
| 2020 | $377.58 | $162.63 | 2.32x | $214.95 | $2.1M | 12.8K | 23 |
| 2021 | $390.67 | $168.92 | 2.31x | $221.75 | $2.3M | 13.4K | 22 |
| 2022 | $364.51 | $158.72 | 2.30x | $205.79 | $2.8M | 17.4K | 23 |
| 2023 | $238.65 | $104.28 | 2.29x | $134.37 | $3.4M | 32.9K | 22 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 12.3K | $8.9M | $720.39 | 1.57x |
| 67028 | Injection of drug into eye | 19.3K | $1.6M | $84.92 | 4.03x |
| J7999 | Compounded drug, not otherwise classified | 10.6K | $708.8K | $66.79 | 3.81x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 21.1K | $614.9K | $29.11 | 2.40x |
| 66984 | Removal of cataract with insertion of prosthetic lens | 1.3K | $614.0K | $475.58 | 2.64x |
| 92134 | Imaging of retina | 19.3K | $613.0K | $31.80 | 2.82x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 5.4K | $530.2K | $98.64 | 2.47x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 6.6K | $415.9K | $63.46 | 2.07x |
| 92014 | Established patient complete exam of visual system | 4.0K | $339.4K | $84.23 | 2.74x |
| J2778 | Injection, ranibizumab, 0.1 mg | 1.0K | $245.8K | $242.13 | 1.91x |
| J3490 | Unclassified drugs | 116 | $204.3K | $1.8K | 2.40x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 2.6K | $176.8K | $68.87 | 2.22x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.4K | $169.7K | $120.51 | 2.48x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 112 | $107.0K | $954.98 | 2.86x |
| 66821 | Removal of recurring cataract in lens capsule using a laser | 426 | $106.7K | $250.55 | 2.33x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 455 | $71.0K | $155.97 | 1.31x |
| 92004 | New patient complete exam of visual system | 643 | $64.3K | $100.02 | 2.32x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 176 | $61.6K | $349.74 | 3.00x |
| 92136 | Measurement of corneal curvature and depth of eye | 1.4K | $56.2K | $39.52 | 3.45x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 435 | $52.4K | $120.36 | 2.49x |
This provider submits charges 2.19 times higher than what Medicare actually pays.
A markup ratio of 2.19x means for every $100 Medicare pays, this provider initially charges $219. 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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