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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Providers
  3. Atul Jain
👁️
MDIndividual

Atul Jain, M.D.

NPI: 1194905711
San Diego, CA
10 years of data
Ophthalmology
$19.7M
Total Payments
160
Beneficiaries
168.4K
Services
1.96x
Markup Ratio

Peer Comparison

99th
percentile in specialty
This provider$19.7M
Specialty median$383.7K

📋 Key Findings

1Billed $19.7M over 10 years
21.96x markup ratio
399th percentile in Ophthalmology by payments
467 services/day — unusually high
5Payments surged 57% in 2019
63 procedures with >3x markup

This provider averages 67 services per working day

Based on 168.4K total services over 10 years (250 working days/year). Learn about impossible service volumes →

🔎 Data Analysis

This provider's $19.7M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.

Averaging 67 services per working day raises questions about billing patterns.

Medicare payments to this provider grew 124% from 2014 to 2023.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

📈

Notable: Payments increased 57% in 2019

Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$411.93$214.311.92x$197.62$1.6M7.3K20
2015$414.49$216.411.92x$198.08$1.4M6.3K18
2016$368.45$187.751.96x$180.70$1.2M6.3K14
2017$368.98$191.001.93x$177.98$1.2M6.5K12
2018$373.12$192.561.94x$180.56$945.1K4.9K15
2019$400.13$199.132.01x$201.00$1.5M7.5K15
2020$449.30$223.052.01x$226.25$2.3M10.4K14
2021$451.91$225.852.00x$226.06$3.1M13.7K17
2022$351.00$174.842.01x$176.16$3.0M17.0K17
2023$74.10$39.481.88x$34.62$3.5M88.5K18

Top Procedures (20)

J0178Injection, aflibercept, 1 mg
$11.4M
15.4K services$740.76/svc1.63x markup
J2777Injection, faricimab-svoa, 0.1 mg
$2.4M
82.7K services$29.13/svc1.53x markup
J2778Injection, ranibizumab, 0.1 mg
$1.4M
5.0K services$281.09/svc1.76x markup
67028Injection of drug into eye⚠ 6.1x markup
$1.2M
13.1K services$88.46/svc6.07x markup
92014Established patient complete exam of visual system
$836.8K
8.6K services$97.53/svc1.76x markup
92012Established patient problem focused exam of visual system
$735.3K
10.2K services$71.90/svc1.66x markup
92134Imaging of retina
$687.0K
20.3K services$33.92/svc2.66x markup
J3490Unclassified drugs
$209.7K
116 services$1.8K/svc1.46x markup
92250Photography of the retina
$115.7K
2.8K services$40.83/svc2.52x markup
92004New patient complete exam of visual system
$110.1K
953 services$115.57/svc1.81x markup
65778Insertion of amniotic membrane to eye surface
$103.2K
80 services$1.3K/svc1.55x markup
99204New patient office or other outpatient visit, 45-59 minutes
$96.7K
792 services$122.15/svc1.84x markup
J9035Injection, bevacizumab, 10 mg
$64.4K
1.1K services$60.13/svc1.66x markup
J7999Compounded drug, not otherwise classified
$62.7K
1.1K services$57.34/svc1.74x markup
92235Exam of retinal blood vessels using a special camera after injection of a dye
$53.4K
613 services$87.07/svc2.58x markup
99213Established patient office or other outpatient visit, 20-29 minutes
$41.0K
542 services$75.58/svc1.36x markup
J3590Unclassified biologics
$32.6K
620 services$52.55/svc1.90x markup
92202Extended exam of the back part of the eye with optic nerve drawing⚠ 7.6x markup
$28.8K
2.3K services$12.63/svc7.60x markup
67145Photocoagulation treatment to prevent detachment of retina
$25.4K
65 services$390.86/svc2.69x markup
67210Laser destruction of retinal growth, 1 or more sessions⚠ 3.3x markup
$22.3K
51 services$436.85/svc3.32x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
J0178Injection, aflibercept, 1 mg15.4K$11.4M$740.761.63x
J2777Injection, faricimab-svoa, 0.1 mg82.7K$2.4M$29.131.53x
J2778Injection, ranibizumab, 0.1 mg5.0K$1.4M$281.091.76x
67028Injection of drug into eye13.1K$1.2M$88.466.07x
92014Established patient complete exam of visual system8.6K$836.8K$97.531.76x
92012Established patient problem focused exam of visual system10.2K$735.3K$71.901.66x
92134Imaging of retina20.3K$687.0K$33.922.66x
J3490Unclassified drugs116$209.7K$1.8K1.46x
92250Photography of the retina2.8K$115.7K$40.832.52x
92004New patient complete exam of visual system953$110.1K$115.571.81x
65778Insertion of amniotic membrane to eye surface80$103.2K$1.3K1.55x
99204New patient office or other outpatient visit, 45-59 minutes792$96.7K$122.151.84x
J9035Injection, bevacizumab, 10 mg1.1K$64.4K$60.131.66x
J7999Compounded drug, not otherwise classified1.1K$62.7K$57.341.74x
92235Exam of retinal blood vessels using a special camera after injection of a dye613$53.4K$87.072.58x
99213Established patient office or other outpatient visit, 20-29 minutes542$41.0K$75.581.36x
J3590Unclassified biologics620$32.6K$52.551.90x
92202Extended exam of the back part of the eye with optic nerve drawing2.3K$28.8K$12.637.60x
67145Photocoagulation treatment to prevent detachment of retina65$25.4K$390.862.69x
67210Laser destruction of retinal growth, 1 or more sessions51$22.3K$436.853.32x

Markup Analysis

Charge-to-Payment Ratio

1.96x

This provider submits charges 1.96 times higher than what Medicare actually pays.

What This Means

A markup ratio of 1.96x means for every $100 Medicare pays, this provider initially charges $196. This is lower than the national average.

Location

San Diego, CA

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

Similar Providers

Other Ophthalmology providers in CA for peer comparison.

Atul Jain (you)
$19.7M
Nathan Steinle, M.D.
$63.1M
Stephen Couvillion, MD
$47.7M
Margaret Chang, M.D.
$47.6M
David Boyer, MD
$47.5M
Alessandro Castellarin, M.D.
$46.9M
Show detailed table ▾
ProviderLocationTotal PaymentsStatus
Nathan Steinle, M.D.Santa Barbara, CA$63.1M✓ Clear
Stephen Couvillion, MDSanta Barbara, CA$47.7M✓ Clear
Margaret Chang, M.D.Sacramento, CA$47.6M✓ Clear
David Boyer, MDLos Angeles, CA$47.5M✓ Clear
Alessandro Castellarin, M.D.Santa Barbara, CA$46.9M✓ Clear

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Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • National Plan and Provider Enumeration System (NPPES)

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.

Believe this data is inaccurate? Dispute this data