This provider's $19.6M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 941% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 95% in 2015
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 | $182.09 | $104.11 | 1.75x | $77.98 | $394.7K | 3.8K | 12 |
| 2015 | $213.00 | $119.64 | 1.78x | $93.36 | $769.1K | 6.4K | 15 |
| 2016 | $223.08 | $125.10 | 1.78x | $97.98 | $990.7K | 7.9K | 14 |
| 2017 | $220.96 | $125.02 | 1.77x | $95.94 | $1.3M | 10.3K | 15 |
| 2018 | $233.49 | $132.39 | 1.76x | $101.10 | $1.7M | 12.9K | 18 |
| 2019 | $254.37 | $148.13 | 1.72x | $106.24 | $2.2M | 15.0K | 14 |
| 2020 | $340.94 | $184.77 | 1.85x | $156.17 | $2.4M | 13.0K | 18 |
| 2021 | $465.39 | $188.25 | 2.47x | $277.14 | $2.4M | 12.7K | 17 |
| 2022 | $634.54 | $197.79 | 3.21x | $436.75 | $3.3M | 16.8K | 17 |
| 2023 | $633.30 | $155.54 | 4.07x | $477.76 | $4.1M | 26.4K | 20 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 16.0K | $11.6M | $724.38 | 2.23x |
| 92014 | Established patient complete exam of visual system | 19.4K | $2.1M | $107.30 | 1.98x |
| J2778 | Injection, ranibizumab, 0.1 mg | 4.7K | $1.2M | $267.93 | 2.07x |
| 67028 | Injection of drug into eye | 10.7K | $1.1M | $103.06 | 5.24x |
| 92134 | Imaging of retina | 22.3K | $823.3K | $36.87 | 5.16x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 14.8K | $332.5K | $22.47 | 2.10x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 2.2K | $302.2K | $135.17 | 1.93x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 3.0K | $297.9K | $99.83 | 2.02x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 9.1K | $265.6K | $29.13 | 4.29x |
| J3590 | Unclassified biologics | 97 | $237.4K | $2.4K | 3.07x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 1.3K | $202.3K | $158.78 | 2.82x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 1.6K | $151.6K | $92.74 | 2.59x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 239 | $151.5K | $633.89 | 4.26x |
| 92202 | Extended exam of the back part of the eye with optic nerve drawing | 8.9K | $124.0K | $13.98 | 5.86x |
| J9035 | Injection, bevacizumab, 10 mg | 1.9K | $111.1K | $58.44 | 1.70x |
| 92250 | Photography of the retina | 1.7K | $93.3K | $54.07 | 2.28x |
| 66986 | Exchange of prosthetic lens | 100 | $82.7K | $827.26 | 2.84x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 2.7K | $65.7K | $24.22 | 2.18x |
| 67041 | Removal of membrane of retina | 58 | $59.6K | $1.0K | 2.80x |
| J3490 | Unclassified drugs | 28 | $49.4K | $1.8K | 3.14x |
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.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Other Ophthalmology providers in MD for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Michael Elman, M.D. | Baltimore, MD | $68.5M | ✓ Clear |
| David Warrow, M.D. | Hagerstown, MD | $65.5M | ✓ Clear |
| Raymond Sjaarda, M.D. | Baltimore, MD | $47.2M | ✓ Clear |
| Allen Hu, MD | Hagerstown, MD | $45.7M | ✓ Clear |
| James Rial, M.D. | Salisbury, MD | $45.2M | ✓ Clear |
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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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