This provider's $18.3M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 1748% from 2015 to 2023.
64% of their billing comes from a single procedure code (J0178 — Injection, aflibercept, 1 mg).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 309% 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 |
|---|---|---|---|---|---|---|---|
| 2015 | $251.29 | $101.09 | 2.49x | $150.20 | $181.5K | 1.8K | 12 |
| 2016 | $376.69 | $155.87 | 2.42x | $220.82 | $741.6K | 4.8K | 16 |
| 2017 | $441.50 | $193.96 | 2.28x | $247.54 | $1.2M | 6.0K | 17 |
| 2018 | $517.16 | $227.26 | 2.28x | $289.90 | $1.6M | 7.2K | 18 |
| 2019 | $602.13 | $267.94 | 2.25x | $334.19 | $2.9M | 10.7K | 19 |
| 2020 | $634.43 | $281.30 | 2.26x | $353.13 | $2.6M | 9.3K | 20 |
| 2021 | $622.41 | $278.59 | 2.23x | $343.82 | $2.6M | 9.4K | 16 |
| 2022 | $520.57 | $225.74 | 2.31x | $294.83 | $3.2M | 14.0K | 17 |
| 2023 | $148.05 | $66.30 | 2.23x | $81.75 | $3.4M | 50.6K | 18 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 15.9K | $11.7M | $733.55 | 2.04x |
| J2778 | Injection, ranibizumab, 0.1 mg | 7.5K | $1.8M | $244.43 | 2.13x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 43.9K | $1.3M | $29.03 | 1.72x |
| 67028 | Injection of drug into eye | 12.7K | $1.1M | $87.64 | 4.82x |
| 92134 | Imaging of retina | 18.1K | $537.7K | $29.73 | 3.07x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 293 | $269.6K | $920.11 | 3.12x |
| J7999 | Compounded drug, not otherwise classified | 4.0K | $249.5K | $62.86 | 1.65x |
| 92014 | Established patient complete exam of visual system | 2.7K | $232.2K | $87.57 | 2.17x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.3K | $154.7K | $116.25 | 2.62x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 2.2K | $136.7K | $61.93 | 2.13x |
| J3590 | Unclassified biologics | 130 | $127.3K | $979.50 | 1.64x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 131 | $124.9K | $953.55 | 3.20x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 330 | $82.8K | $250.77 | 1.99x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1.1K | $71.3K | $62.56 | 2.16x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 197 | $67.5K | $342.54 | 2.94x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 91 | $65.5K | $719.27 | 2.54x |
| J3490 | Unclassified drugs | 32 | $55.5K | $1.7K | 1.74x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 348 | $35.1K | $100.87 | 2.26x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 574 | $33.4K | $58.11 | 2.75x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 30 | $31.0K | $1.0K | 3.21x |
This provider submits charges 2.27 times higher than what Medicare actually pays.
A markup ratio of 2.27x means for every $100 Medicare pays, this provider initially charges $227. 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 WA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Charles Sung, MD | Kennewick, WA | $38.3M | ✓ Clear |
| David Spinak, MD | Silverdale, WA | $34.8M | ✓ 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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