This provider's $4.1M in total Medicare payments ranks in the 95th percentile of Ophthalmology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 68% in 2021
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 | $1.3K | $286.37 | 4.45x | $988.42 | $432.4K | 2.4K | 2.0K |
| 2015 | $1.3K | $273.69 | 4.80x | $1.0K | $380.7K | 2.3K | 1.9K |
| 2016 | $1.3K | $253.42 | 5.18x | $1.1K | $341.3K | 2.2K | 1.9K |
| 2017 | $1.2K | $248.10 | 4.80x | $942.60 | $370.9K | 2.5K | 2.1K |
| 2018 | $1.2K | $252.27 | 4.65x | $919.95 | $370.2K | 2.5K | 2.1K |
| 2019 | $1.2K | $255.69 | 4.84x | $981.43 | $419.2K | 2.6K | 2.3K |
| 2020 | $1.2K | $276.09 | 4.18x | $877.54 | $273.6K | 1.8K | 1.6K |
| 2021 | $1.3K | $258.05 | 4.87x | $998.86 | $460.0K | 2.8K | 2.4K |
| 2022 | $1.3K | $261.25 | 4.82x | $998.25 | $476.3K | 2.9K | 2.6K |
| 2023 | $1.3K | $254.57 | 5.23x | $1.1K | $532.0K | 3.2K | 2.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 67904 | Repair of tendon of upper eyelid | 711 | $522.1K | $734.32 | 4.89x |
| 14060 | Tissue transfer repair of wound (10 sq centimeters or less) of eyelids, nose, ears, and/or lips | 1.1K | $407.6K | $382.75 | 4.13x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.1K | $341.2K | $66.97 | 1.88x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 451 | $316.4K | $701.57 | 3.47x |
| 68810 | Insertion of probe into the tear duct | 1.1K | $237.2K | $214.67 | 3.22x |
| 67900 | Repair of brow paralysis | 537 | $211.6K | $394.00 | 9.73x |
| 15260 | Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less) | 267 | $207.4K | $776.85 | 1.96x |
| 15576 | Creation of flap graft to eyelids, nose, ears, lips, or mouth | 384 | $187.4K | $488.03 | 2.57x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.5K | $164.7K | $109.63 | 1.86x |
| 67917 | Extensive repair of turning-outward eyelid defect | 520 | $153.8K | $295.71 | 11.29x |
| 68720 | Creation of drainage tract from tear sac to the nasal cavity | 208 | $141.1K | $678.45 | 3.83x |
| 67966 | Removal of over one-fourth of the eyelid involving lid margin | 340 | $133.5K | $392.75 | 5.30x |
| 67840 | Removal of eyelid growth | 491 | $113.5K | $231.23 | 3.25x |
| 64612 | Injection of chemical for destruction of nerve muscles on one side of face | 678 | $102.6K | $151.25 | 3.78x |
| 92285 | Photography of content of eyes | 4.1K | $83.5K | $20.37 | 3.04x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 646 | $80.7K | $124.94 | 1.65x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 761 | $78.8K | $103.55 | 1.61x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 963 | $72.6K | $75.35 | 1.68x |
| 68815 | Probing of nasal-tear duct with insertion of tube or stent | 507 | $69.9K | $137.86 | 8.10x |
| 31200 | Partial removal of nasal sinus | 179 | $53.3K | $297.54 | 5.38x |
This provider submits charges 4.25 times higher than what Medicare actually pays.
A markup ratio of 4.25x means for every $100 Medicare pays, this provider initially charges $425. 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 NY for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Jonathan Jonisch, MD | Great Neck, NY | $52.3M | ✓ Clear |
| Jeffrey Josef, M.D. | Suffern, NY | $52.2M | ✓ Clear |
| Brett Rosenblatt | Great Neck, NY | $50.0M | ✓ Clear |
| Kenneth Graham | Great Neck, NY | $47.1M | ✓ Clear |
| Glenn Stoller, M.D. | Rockville Centre, NY | $46.4M | ✓ 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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