This provider's $31.4M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 70% from 2014 to 2023.
79% of their billing comes from a single procedure code (J0178 — Injection, aflibercept, 1 mg).
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 | $490.97 | $256.09 | 1.92x | $234.88 | $2.1M | 8.1K | 20 |
| 2015 | $557.53 | $292.21 | 1.91x | $265.32 | $2.8M | 9.5K | 20 |
| 2016 | $567.14 | $298.52 | 1.90x | $268.62 | $2.9M | 9.6K | 16 |
| 2017 | $586.43 | $302.78 | 1.94x | $283.65 | $3.2M | 10.7K | 20 |
| 2018 | $587.93 | $298.16 | 1.97x | $289.77 | $3.2M | 10.6K | 19 |
| 2019 | $586.78 | $295.53 | 1.99x | $291.25 | $3.3M | 11.3K | 18 |
| 2020 | $601.84 | $303.17 | 1.99x | $298.67 | $3.4M | 11.3K | 16 |
| 2021 | $614.27 | $305.09 | 2.01x | $309.18 | $3.6M | 11.8K | 20 |
| 2022 | $511.85 | $253.33 | 2.02x | $258.52 | $3.3M | 13.1K | 18 |
| 2023 | $348.59 | $170.39 | 2.05x | $178.20 | $3.5M | 20.8K | 19 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 33.5K | $24.7M | $735.70 | 1.80x |
| J2778 | Injection, ranibizumab, 0.1 mg | 5.4K | $1.5M | $273.70 | 1.97x |
| 67028 | Injection of drug into eye | 17.9K | $1.4M | $79.94 | 3.75x |
| 92134 | Imaging of retina | 23.9K | $711.5K | $29.75 | 2.59x |
| 92014 | Established patient complete exam of visual system | 5.6K | $480.9K | $85.77 | 2.65x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 11.6K | $339.1K | $29.28 | 1.68x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 2.0K | $230.7K | $116.18 | 2.42x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 260 | $229.4K | $882.46 | 3.00x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 1.3K | $205.7K | $157.12 | 1.68x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 3.4K | $199.5K | $58.55 | 2.50x |
| J3590 | Unclassified biologics | 219 | $171.6K | $783.53 | 1.69x |
| 92250 | Photography of the retina | 4.2K | $169.8K | $40.52 | 3.04x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 1.8K | $152.5K | $86.56 | 2.54x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 1.3K | $118.9K | $90.29 | 2.28x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 960 | $115.5K | $120.36 | 1.44x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina, with removal of vitreous fluid | 112 | $109.5K | $977.62 | 2.83x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 131 | $80.3K | $612.90 | 2.74x |
| 67113 | Complex repair of detached retina and drainage of eye fluid between lens and retina | 68 | $68.2K | $1.0K | 2.92x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 159 | $56.1K | $353.08 | 3.44x |
| J3490 | Unclassified drugs | 28 | $49.5K | $1.8K | 1.47x |
This provider submits charges 1.97 times higher than what Medicare actually pays.
A markup ratio of 1.97x means for every $100 Medicare pays, this provider initially charges $197. This is lower 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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