This provider averages 53 services per working day
Based on 133.6K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $13.5M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 53 services per working day raises questions about billing patterns.
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 | $493.36 | $246.96 | 2.00x | $246.40 | $1.4M | 12.3K | 5.9K |
| 2015 | $746.12 | $350.21 | 2.13x | $395.91 | $1.5M | 13.1K | 6.6K |
| 2016 | $922.88 | $237.94 | 3.88x | $684.94 | $1.5M | 14.0K | 7.2K |
| 2017 | $775.27 | $186.71 | 4.15x | $588.56 | $1.3M | 13.8K | 7.3K |
| 2018 | $791.15 | $197.53 | 4.01x | $593.62 | $1.3M | 14.1K | 7.4K |
| 2019 | $755.03 | $184.62 | 4.09x | $570.41 | $1.3M | 14.9K | 7.9K |
| 2020 | $785.75 | $198.86 | 3.95x | $586.89 | $1.2M | 12.2K | 6.6K |
| 2021 | $748.02 | $185.37 | 4.04x | $562.65 | $1.2M | 13.2K | 6.8K |
| 2022 | $876.01 | $221.77 | 3.95x | $654.24 | $1.2M | 13.4K | 6.7K |
| 2023 | $760.55 | $231.86 | 3.28x | $528.69 | $1.4M | 12.5K | 6.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 6.2K | $4.7M | $749.76 | 1.67x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 23.8K | $2.1M | $87.79 | 8.12x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 20.5K | $1.7M | $85.01 | 2.34x |
| 92134 | Diagnostic imaging of retina | 33.8K | $1.1M | $32.74 | 12.48x |
| 67028 | Injection of drug into eye | 11.2K | $1.1M | $98.37 | 5.44x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 17.8K | $1.0M | $59.07 | 2.26x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 654 | $286.4K | $437.90 | 4.07x |
| J2778 | Injection, ranibizumab, 0.1 mg | 902 | $250.4K | $277.60 | 1.88x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 520 | $201.3K | $387.08 | 5.95x |
| J9035 | Injection, bevacizumab, 10 mg | 3.4K | $191.5K | $56.37 | 1.34x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 8.1K | $177.5K | $22.00 | 4.30x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 335 | $93.9K | $280.36 | 2.30x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 734 | $84.3K | $114.89 | 2.50x |
| 67220 | Destruction of vascular growth between retina and sclera, 1 or more sessions | 158 | $71.4K | $452.07 | 6.74x |
| J3490 | Unclassified drugs | 35 | $57.9K | $1.7K | 1.61x |
| 67041 | Removal of membrane from the retina | 48 | $46.7K | $973.10 | 2.31x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 270 | $42.4K | $157.22 | 2.09x |
| 67145 | Preventive retinal detachment treatment by heat or laser, 1 or more sessions | 87 | $38.5K | $442.54 | 2.78x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 30 | $37.0K | $1.2K | 2.92x |
| 92201 | Extended examination of eye with drawing of retina | 1.8K | $32.7K | $18.61 | 5.36x |
This provider submits charges 4.22 times higher than what Medicare actually pays.
A markup ratio of 4.22x means for every $100 Medicare pays, this provider initially charges $422. 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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