This provider averages 64 services per working day
Based on 159.4K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $14.5M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 64 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 10880% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1495% in 2016
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 | $448.69 | $168.41 | 2.66x | $280.28 | $39.1K | 232 | 5 |
| 2015 | $230.66 | $60.12 | 3.84x | $170.54 | $12.5K | 208 | 5 |
| 2016 | $339.80 | $90.16 | 3.77x | $249.64 | $199.4K | 2.2K | 13 |
| 2017 | $408.30 | $109.67 | 3.72x | $298.63 | $1.3M | 12.2K | 24 |
| 2018 | $377.06 | $110.58 | 3.41x | $266.48 | $1.5M | 13.6K | 22 |
| 2019 | $504.95 | $199.00 | 2.54x | $305.95 | $960.6K | 4.8K | 11 |
| 2020 | $605.03 | $169.69 | 3.57x | $435.34 | $881.7K | 5.2K | 15 |
| 2021 | $734.47 | $203.00 | 3.62x | $531.47 | $2.0M | 10.0K | 22 |
| 2022 | $513.22 | $133.71 | 3.84x | $379.51 | $3.3M | 24.4K | 21 |
| 2023 | $141.17 | $49.61 | 2.85x | $91.56 | $4.3M | 86.5K | 25 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 7.4K | $5.4M | $726.74 | 2.77x |
| J2778 | Injection, ranibizumab, 0.1 mg | 14.8K | $3.3M | $220.37 | 3.89x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 79.7K | $2.3M | $28.99 | 2.42x |
| 67028 | Injection of drug into eye | 12.5K | $1.1M | $85.94 | 6.29x |
| 92134 | Imaging of retina | 18.8K | $559.3K | $29.67 | 3.95x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 3.0K | $252.6K | $84.01 | 3.06x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 2.2K | $252.0K | $114.32 | 3.07x |
| 92014 | Established patient complete exam of visual system | 2.9K | $251.2K | $87.19 | 3.00x |
| J9035 | Injection, bevacizumab, 10 mg | 2.3K | $134.1K | $57.67 | 2.79x |
| J3590 | Unclassified biologics | 3.3K | $127.4K | $39.09 | 2.22x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 138 | $119.5K | $865.70 | 4.45x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 501 | $108.5K | $216.54 | 3.87x |
| 92012 | Established patient problem focused exam of visual system | 1.7K | $108.4K | $62.17 | 1.90x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 672 | $104.6K | $155.63 | 2.30x |
| 67041 | Removal of membrane of retina | 103 | $85.5K | $829.61 | 4.25x |
| J7999 | Compounded drug, not otherwise classified | 980 | $65.7K | $67.03 | 4.93x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 61 | $50.7K | $831.21 | 4.68x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 255 | $38.1K | $149.61 | 3.50x |
| J3490 | Unclassified drugs | 23 | $36.0K | $1.6K | 3.20x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 47 | $30.6K | $650.78 | 4.77x |
This provider submits charges 3.35 times higher than what Medicare actually pays.
A markup ratio of 3.35x means for every $100 Medicare pays, this provider initially charges $335. This is higher than the national average.
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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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