This provider averages 86 services per working day
Based on 214.9K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $28.7M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 86 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 166% 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 | $361.61 | $107.09 | 3.38x | $254.52 | $1.5M | 14.4K | 21 |
| 2015 | $500.59 | $139.52 | 3.59x | $361.07 | $2.0M | 14.0K | 23 |
| 2016 | $600.91 | $161.72 | 3.72x | $439.19 | $2.2M | 13.9K | 22 |
| 2017 | $680.68 | $176.85 | 3.85x | $503.83 | $2.5M | 14.1K | 24 |
| 2018 | $764.72 | $196.03 | 3.90x | $568.69 | $3.1M | 15.7K | 21 |
| 2019 | $855.64 | $215.45 | 3.97x | $640.19 | $2.9M | 13.6K | 20 |
| 2020 | $1.0K | $250.26 | 4.05x | $764.01 | $3.4M | 13.7K | 17 |
| 2021 | $1.0K | $248.06 | 4.16x | $783.02 | $3.5M | 13.9K | 14 |
| 2022 | $882.47 | $204.72 | 4.31x | $677.75 | $3.5M | 17.2K | 17 |
| 2023 | $204.48 | $48.42 | 4.22x | $156.06 | $4.1M | 84.6K | 15 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 21.0K | $15.5M | $738.76 | 4.07x |
| J2778 | Injection, ranibizumab, 0.1 mg | 11.7K | $3.2M | $273.56 | 4.52x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 78.8K | $2.3M | $28.91 | 4.02x |
| 67028 | Injection of drug into eye | 18.7K | $1.7M | $93.38 | 4.77x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 12.2K | $961.8K | $78.69 | 3.14x |
| 92012 | Established patient problem focused exam of visual system | 13.9K | $890.5K | $63.95 | 2.83x |
| 92134 | Imaging of retina | 24.5K | $792.0K | $32.34 | 3.21x |
| 92014 | Established patient complete exam of visual system | 6.9K | $644.8K | $93.67 | 3.57x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 3.1K | $485.4K | $156.52 | 2.96x |
| 92250 | Photography of the retina | 8.3K | $351.6K | $42.61 | 3.44x |
| J9035 | Injection, bevacizumab, 10 mg | 6.2K | $341.6K | $55.49 | 3.52x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 294 | $281.3K | $956.97 | 3.40x |
| 92004 | New patient complete exam of visual system | 2.3K | $252.1K | $107.98 | 3.04x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina, with removal of vitreous fluid | 151 | $159.4K | $1.1K | 3.21x |
| J7999 | Compounded drug, not otherwise classified | 2.0K | $138.9K | $70.97 | 3.80x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 183 | $129.8K | $709.38 | 3.18x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 290 | $115.1K | $397.04 | 5.26x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 618 | $75.5K | $122.19 | 3.65x |
| 67210 | Destruction of growth of retina using a laser | 174 | $72.7K | $417.84 | 2.70x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 71 | $71.5K | $1.0K | 3.64x |
This provider submits charges 3.98 times higher than what Medicare actually pays.
A markup ratio of 3.98x means for every $100 Medicare pays, this provider initially charges $398. 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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