This provider averages 52 services per working day
Based on 129.7K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $14.6M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 52 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 60% 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 | $292.05 | $219.20 | 1.33x | $72.85 | $1.1M | 10.9K | 3.6K |
| 2015 | $305.91 | $233.55 | 1.31x | $72.36 | $1.3M | 11.9K | 4.1K |
| 2016 | $257.76 | $189.05 | 1.36x | $68.71 | $1.6M | 13.1K | 4.4K |
| 2017 | $220.96 | $159.86 | 1.38x | $61.10 | $1.4M | 11.3K | 3.4K |
| 2018 | $213.95 | $154.40 | 1.39x | $59.55 | $1.3M | 11.2K | 4.0K |
| 2019 | $257.51 | $186.96 | 1.38x | $70.55 | $1.4M | 13.0K | 5.0K |
| 2020 | $205.74 | $151.85 | 1.35x | $53.89 | $1.4M | 12.9K | 4.6K |
| 2021 | $190.91 | $137.99 | 1.38x | $52.92 | $1.6M | 14.6K | 4.9K |
| 2022 | $203.91 | $130.00 | 1.57x | $73.91 | $1.7M | 15.3K | 4.6K |
| 2023 | $254.54 | $129.24 | 1.97x | $125.30 | $1.8M | 15.6K | 4.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 5.5K | $4.1M | $741.41 | 1.41x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 30.5K | $3.1M | $100.19 | 1.54x |
| 67028 | Injection of drug into eye | 19.5K | $1.7M | $88.40 | 1.46x |
| 92134 | Diagnostic imaging of retina | 29.9K | $1.0M | $34.77 | 1.50x |
| 92242 | Imaging of blood vessels in back of eye using fluorescein and indocyanine-green dye | 4.1K | $867.6K | $211.76 | 1.48x |
| J2778 | Injection, ranibizumab, 0.1 mg | 2.9K | $856.4K | $296.14 | 1.32x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 8.8K | $787.4K | $89.62 | 1.50x |
| J9035 | Injection, bevacizumab, 10 mg | 10.4K | $580.8K | $55.72 | 1.44x |
| 92250 | Photography of the retina | 8.5K | $409.7K | $48.36 | 1.50x |
| 92240 | Examination of eye using an endoscope | 1.9K | $382.3K | $203.59 | 1.41x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.1K | $273.5K | $130.97 | 1.54x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 3.7K | $268.7K | $73.06 | 1.36x |
| 92287 | Imaging and evaluation of deep cells of the eye | 1.1K | $144.2K | $133.53 | 1.49x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 93 | $47.9K | $514.91 | 1.35x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 74 | $32.9K | $444.55 | 1.32x |
| 92273 | Full field recording of retinal electrical responses to external stimuli with interpretation and report | 231 | $25.2K | $109.02 | 1.38x |
| 67040 | Laser destruction of eye fluid (vitreous) between the lens and retina | 16 | $9.6K | $600.80 | 1.48x |
| 76512 | Ultrasound of eye disease, growth, or structure | 153 | $8.7K | $57.13 | 1.60x |
| 92275 | Recording of retinal electrical responses to external stimuli | 47 | $5.8K | $124.20 | 1.45x |
| 67041 | Removal of membrane from the retina | 11 | $5.1K | $463.29 | 1.40x |
This provider submits charges 1.46 times higher than what Medicare actually pays.
A markup ratio of 1.46x means for every $100 Medicare pays, this provider initially charges $146. 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 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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