This provider averages 122 services per working day
Based on 305.5K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $53.3M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 122 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 | $359.24 | $213.39 | 1.68x | $145.85 | $5.1M | 23.9K | 20 |
| 2015 | $317.68 | $235.59 | 1.35x | $82.09 | $5.4M | 23.0K | 18 |
| 2016 | $318.71 | $240.16 | 1.33x | $78.55 | $5.5M | 22.9K | 19 |
| 2017 | $330.66 | $247.33 | 1.34x | $83.33 | $5.8M | 23.6K | 21 |
| 2018 | $311.03 | $230.57 | 1.35x | $80.46 | $5.7M | 24.7K | 19 |
| 2019 | $330.01 | $238.81 | 1.38x | $91.20 | $5.9M | 24.8K | 17 |
| 2020 | $346.31 | $245.28 | 1.41x | $101.03 | $5.0M | 20.4K | 16 |
| 2021 | $352.55 | $244.15 | 1.44x | $108.40 | $4.9M | 20.1K | 16 |
| 2022 | $230.17 | $157.61 | 1.46x | $72.56 | $5.3M | 33.4K | 17 |
| 2023 | $79.26 | $53.05 | 1.49x | $26.21 | $4.7M | 88.8K | 15 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2778 | Injection, ranibizumab, 0.1 mg | 82.0K | $23.0M | $281.11 | 1.46x |
| J0178 | Injection, aflibercept, 1 mg | 25.2K | $18.8M | $743.83 | 1.34x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 90.4K | $2.6M | $28.97 | 1.33x |
| 67028 | Injection of drug into eye | 26.0K | $2.3M | $89.96 | 1.66x |
| 92014 | Established patient complete exam of visual system | 19.9K | $1.7M | $87.82 | 1.46x |
| J3590 | Unclassified biologics | 1.1K | $1.1M | $1.1K | 1.30x |
| 92134 | Imaging of retina | 32.5K | $987.3K | $30.36 | 1.57x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 9.3K | $715.8K | $76.75 | 1.68x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 2.8K | $432.9K | $155.40 | 1.33x |
| 67210 | Destruction of growth of retina using a laser | 664 | $268.0K | $403.61 | 1.48x |
| 92250 | Photography of the retina | 5.5K | $260.7K | $47.18 | 1.63x |
| 67041 | Removal of membrane of retina | 244 | $221.7K | $908.74 | 1.35x |
| 92004 | New patient complete exam of visual system | 1.5K | $159.0K | $105.86 | 1.47x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 417 | $151.5K | $363.30 | 1.44x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 137 | $138.3K | $1.0K | 1.35x |
| 67042 | Removal of membrane from the retina, pars plana approach | 88 | $84.8K | $964.15 | 1.39x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 112 | $74.6K | $666.08 | 1.41x |
| 99214 | Established patient outpatient visit, total time 30-39 minutes | 613 | $59.9K | $97.68 | 1.32x |
| 67515 | Injection of drug or substance into membrane covering eyeball | 579 | $35.0K | $60.53 | 1.52x |
| 92012 | Established patient problem focused exam of visual system | 589 | $34.9K | $59.29 | 1.53x |
This provider submits charges 1.42 times higher than what Medicare actually pays.
A markup ratio of 1.42x means for every $100 Medicare pays, this provider initially charges $142. 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 VA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| James Tiedeman | Fishersville, VA | $51.1M | ✓ Clear |
| Juan Astruc, M.D. | Richmond, VA | $46.6M | ✓ Clear |
| Kapil Kapoor, MD | Norfolk, VA | $43.0M | ✓ Clear |
| Alan Wagner, MD | Norfolk, VA | $42.8M | ✓ Clear |
| Mohit Nanda, MD | Charlottesville, VA | $41.2M | ✓ 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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