This provider averages 86 services per working day
Based on 215.3K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $43.1M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 86 services per working day raises questions about billing patterns.
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 | $537.85 | $192.63 | 2.79x | $345.22 | $4.6M | 23.7K | 13 |
| 2015 | $597.06 | $206.20 | 2.90x | $390.86 | $4.6M | 22.2K | 17 |
| 2016 | $616.58 | $206.16 | 2.99x | $410.42 | $4.7M | 23.0K | 16 |
| 2017 | $602.47 | $198.81 | 3.03x | $403.66 | $4.1M | 20.5K | 16 |
| 2018 | $637.28 | $199.82 | 3.19x | $437.46 | $4.8M | 23.8K | 17 |
| 2019 | $769.38 | $203.68 | 3.78x | $565.70 | $4.8M | 23.4K | 17 |
| 2020 | $880.75 | $225.97 | 3.90x | $654.78 | $4.2M | 18.7K | 16 |
| 2021 | $868.37 | $220.76 | 3.93x | $647.61 | $4.1M | 18.5K | 18 |
| 2022 | $849.78 | $203.61 | 4.17x | $646.17 | $3.9M | 19.0K | 15 |
| 2023 | $662.84 | $152.53 | 4.35x | $510.31 | $3.4M | 22.5K | 19 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2778 | Injection, ranibizumab, 0.1 mg | 69.4K | $19.5M | $280.64 | 2.93x |
| J0178 | Injection, aflibercept, 1 mg | 21.2K | $15.6M | $736.44 | 3.40x |
| 67028 | Injection of drug into eye | 25.0K | $2.3M | $91.67 | 5.94x |
| 92014 | Established patient complete exam of visual system | 18.6K | $1.8M | $99.38 | 3.07x |
| 92134 | Imaging of retina | 30.0K | $1.1M | $36.60 | 9.06x |
| 92012 | Established patient problem focused exam of visual system | 11.2K | $819.7K | $73.26 | 2.85x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 16.3K | $349.6K | $21.48 | 3.91x |
| J3590 | Unclassified biologics | 113 | $247.8K | $2.2K | 3.19x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 8.6K | $242.1K | $28.22 | 4.43x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.7K | $219.6K | $130.20 | 3.10x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 725 | $156.9K | $216.36 | 4.62x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 987 | $146.6K | $148.53 | 2.89x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 1.1K | $101.0K | $88.81 | 3.90x |
| 67042 | Removal of membrane from the retina, pars plana approach | 73 | $72.7K | $995.89 | 3.58x |
| 92250 | Photography of the retina | 1.2K | $60.7K | $52.25 | 3.70x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 2.5K | $59.2K | $23.32 | 3.64x |
| 92202 | Extended exam of the back part of the eye with optic nerve drawing | 3.6K | $47.7K | $13.12 | 5.66x |
| J9035 | Injection, bevacizumab, 10 mg | 792 | $45.6K | $57.59 | 7.36x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 62 | $39.5K | $636.59 | 3.61x |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 440 | $36.9K | $83.97 | 3.20x |
This provider submits charges 3.46 times higher than what Medicare actually pays.
A markup ratio of 3.46x means for every $100 Medicare pays, this provider initially charges $346. 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 NJ for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Howard Fine, MD MHSC | New Brunswick, NJ | $44.5M | ✓ Clear |
| Robert Barone, MD | Newton, NJ | $43.3M | ✓ Clear |
| Sumit Shah, M.D. | New Brunswick, NJ | $37.0M | ✓ Clear |
| David Kim, M.D. | Union, NJ | $36.1M | ✓ Clear |
| Leonard Feiner, M.D | Union, NJ | $36.0M | ✓ 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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