This provider averages 63 services per working day
Based on 47.1K total services over 3 years (250 working days/year). Learn about impossible service volumes →
This provider's $4.5M in total Medicare payments ranks in the 96th percentile of Ophthalmology providers nationally.
Averaging 63 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 29710% from 2021 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 9599% in 2022
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 |
|---|---|---|---|---|---|---|---|
| 2021 | $1.5K | $139.77 | 10.73x | $1.4K | $11.3K | 81 | 5 |
| 2022 | $378.90 | $156.69 | 2.42x | $222.21 | $1.1M | 7.0K | 12 |
| 2023 | $199.64 | $84.44 | 2.36x | $115.20 | $3.4M | 40.0K | 21 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 2.8K | $1.9M | $691.83 | 2.17x |
| J2778 | Injection, ranibizumab, 0.1 mg | 5.0K | $952.6K | $190.24 | 2.73x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 31.9K | $928.7K | $29.15 | 1.72x |
| 67028 | Injection of drug into eye | 2.5K | $258.7K | $101.49 | 4.79x |
| J3490 | Unclassified drugs | 48 | $95.4K | $2.0K | 1.60x |
| 92134 | Imaging of retina | 3.0K | $90.6K | $30.00 | 3.07x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 203 | $32.1K | $158.14 | 1.58x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 289 | $27.6K | $95.53 | 2.07x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 39 | $27.1K | $693.68 | 3.58x |
| Q5124 | Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg | 165 | $26.6K | $161.43 | 3.22x |
| 67113 | Complex repair of detached retina and drainage of eye fluid between lens and retina | 30 | $26.3K | $877.18 | 3.37x |
| J7999 | Compounded drug, not otherwise classified | 346 | $24.7K | $71.46 | 1.91x |
| 92014 | Established patient complete exam of visual system | 245 | $22.9K | $93.29 | 2.04x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 130 | $16.0K | $122.92 | 2.47x |
| 67041 | Removal of membrane of retina | 40 | $9.4K | $234.79 | 6.93x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 36 | $8.3K | $230.46 | 7.26x |
| 92004 | New patient complete exam of visual system | 53 | $5.3K | $99.43 | 2.29x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 26 | $4.2K | $160.04 | 6.30x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 46 | $3.9K | $85.73 | 2.00x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 23 | $3.7K | $160.80 | 2.34x |
This provider submits charges 2.4 times higher than what Medicare actually pays.
A markup ratio of 2.4x means for every $100 Medicare pays, this provider initially charges $240. 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 WA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Charles Sung, MD | Kennewick, WA | $38.3M | ✓ Clear |
| David Spinak, MD | Silverdale, WA | $34.8M | ✓ 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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