This provider averages 71 services per working day
Based on 177.0K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $30.9M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 71 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 77% 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 | $436.22 | $157.09 | 2.78x | $279.13 | $2.3M | 14.8K | 20 |
| 2015 | $471.93 | $160.10 | 2.95x | $311.83 | $2.9M | 18.0K | 23 |
| 2016 | $514.30 | $165.70 | 3.10x | $348.60 | $3.4M | 20.3K | 21 |
| 2017 | $523.47 | $167.72 | 3.12x | $355.75 | $2.9M | 17.3K | 16 |
| 2018 | $603.64 | $176.52 | 3.42x | $427.12 | $3.2M | 18.3K | 20 |
| 2019 | $702.79 | $183.80 | 3.82x | $518.99 | $3.0M | 16.4K | 16 |
| 2020 | $862.46 | $220.57 | 3.91x | $641.89 | $3.0M | 13.7K | 15 |
| 2021 | $856.34 | $216.86 | 3.95x | $639.48 | $3.0M | 13.9K | 16 |
| 2022 | $830.14 | $197.90 | 4.19x | $632.24 | $3.0M | 14.9K | 16 |
| 2023 | $583.49 | $141.01 | 4.14x | $442.48 | $4.1M | 29.3K | 19 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 16.1K | $11.8M | $732.76 | 3.41x |
| J2778 | Injection, ranibizumab, 0.1 mg | 38.0K | $10.5M | $275.98 | 3.01x |
| 92014 | Established patient complete exam of visual system | 22.9K | $2.4M | $103.12 | 2.98x |
| 67028 | Injection of drug into eye | 17.8K | $1.6M | $92.67 | 5.66x |
| 92134 | Imaging of retina | 24.1K | $885.1K | $36.80 | 9.41x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 3.4K | $442.6K | $131.99 | 3.07x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 19.1K | $411.7K | $21.60 | 3.89x |
| J3590 | Unclassified biologics | 167 | $385.8K | $2.3K | 3.07x |
| J3490 | Unclassified drugs | 163 | $327.2K | $2.0K | 3.15x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 11.2K | $326.3K | $29.09 | 4.30x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 3.0K | $271.8K | $89.85 | 3.85x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 1.1K | $247.1K | $215.80 | 4.63x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 1.5K | $184.3K | $120.36 | 3.07x |
| 92250 | Photography of the retina | 3.1K | $162.4K | $51.98 | 3.72x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 290 | $134.8K | $464.70 | 6.12x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 5.2K | $121.9K | $23.56 | 3.61x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 469 | $73.7K | $157.25 | 2.73x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 157 | $70.3K | $447.82 | 3.65x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 138 | $58.8K | $426.14 | 2.87x |
| 92202 | Extended exam of the back part of the eye with optic nerve drawing | 4.3K | $58.8K | $13.52 | 6.40x |
This provider submits charges 3.57 times higher than what Medicare actually pays.
A markup ratio of 3.57x means for every $100 Medicare pays, this provider initially charges $357. 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 |
| Jonathan Prenner, MD | New Brunswick, NJ | $43.1M | ✓ Clear |
| Sumit Shah, M.D. | New Brunswick, NJ | $37.0M | ✓ Clear |
| David Kim, M.D. | Union, NJ | $36.1M | ✓ 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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