This provider averages 97 services per working day
Based on 241.7K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $40.6M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 97 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 50% from 2014 to 2023.
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 | $270.69 | $158.89 | 1.70x | $111.80 | $3.1M | 19.7K | 28 |
| 2015 | $431.14 | $172.13 | 2.50x | $259.01 | $3.6M | 20.9K | 27 |
| 2016 | $438.61 | $173.52 | 2.53x | $265.09 | $3.3M | 19.1K | 23 |
| 2017 | $468.76 | $182.25 | 2.57x | $286.51 | $3.8M | 21.1K | 23 |
| 2018 | $390.55 | $161.57 | 2.42x | $228.98 | $3.3M | 20.7K | 21 |
| 2019 | $441.02 | $167.16 | 2.64x | $273.86 | $3.6M | 21.5K | 22 |
| 2020 | $544.82 | $182.88 | 2.98x | $361.94 | $4.3M | 23.7K | 22 |
| 2021 | $766.12 | $202.95 | 3.77x | $563.17 | $5.4M | 26.6K | 19 |
| 2022 | $706.36 | $201.69 | 3.50x | $504.67 | $5.3M | 26.3K | 20 |
| 2023 | $375.78 | $111.80 | 3.36x | $263.98 | $4.7M | 42.1K | 20 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 22.8K | $16.9M | $740.41 | 3.05x |
| J2778 | Injection, ranibizumab, 0.1 mg | 42.1K | $11.3M | $268.14 | 2.72x |
| 67028 | Injection of drug into eye | 25.9K | $2.4M | $93.44 | 5.00x |
| 92012 | Established patient problem focused exam of visual system | 22.3K | $1.5M | $68.63 | 2.35x |
| 92014 | Established patient complete exam of visual system | 15.6K | $1.5M | $95.26 | 2.03x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 13.7K | $1.1M | $83.86 | 2.06x |
| 92134 | Imaging of retina | 33.3K | $1.1M | $33.42 | 2.70x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 27.4K | $797.4K | $29.14 | 2.74x |
| 92250 | Photography of the retina | 12.4K | $595.4K | $48.13 | 2.05x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 3.0K | $479.3K | $157.78 | 2.83x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 3.5K | $441.8K | $124.68 | 2.12x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 1.1K | $432.3K | $388.08 | 2.75x |
| J7999 | Compounded drug, not otherwise classified | 5.9K | $385.1K | $65.52 | 1.89x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 1.4K | $298.9K | $219.47 | 3.05x |
| 67210 | Destruction of growth of retina using a laser | 656 | $281.4K | $428.92 | 2.00x |
| 67042 | Removal of membrane from the retina, pars plana approach | 149 | $150.6K | $1.0K | 3.27x |
| J3590 | Unclassified biologics | 1.6K | $131.1K | $80.85 | 2.66x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 448 | $72.9K | $162.75 | 1.74x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 180 | $70.6K | $392.10 | 2.30x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 62 | $69.8K | $1.1K | 2.24x |
This provider submits charges 2.9 times higher than what Medicare actually pays.
A markup ratio of 2.9x means for every $100 Medicare pays, this provider initially charges $290. 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 CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Nathan Steinle, M.D. | Santa Barbara, CA | $63.1M | ✓ Clear |
| Stephen Couvillion, MD | Santa Barbara, CA | $47.7M | ✓ Clear |
| Margaret Chang, M.D. | Sacramento, CA | $47.6M | ✓ Clear |
| David Boyer, MD | Los Angeles, CA | $47.5M | ✓ Clear |
| Alessandro Castellarin, M.D. | Santa Barbara, CA | $46.9M | ✓ 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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