This provider averages 51 services per working day
Based on 127.4K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $8.8M in total Medicare payments ranks in the 98th percentile of Ophthalmology providers nationally.
Averaging 51 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 155387% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 5333% in 2021
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 | $157.68 | $33.80 | 4.67x | $123.88 | $2.5K | 74 | 2 |
| 2015 | $663.58 | $57.29 | 11.58x | $606.29 | $10.3K | 179 | 5 |
| 2016 | $191.47 | $41.60 | 4.60x | $149.87 | $2.1K | 51 | 2 |
| 2017 | $610.34 | $73.26 | 8.33x | $537.08 | $36.8K | 503 | 8 |
| 2018 | $491.82 | $45.60 | 10.79x | $446.22 | $21.2K | 465 | 4 |
| 2019 | $520.87 | $46.58 | 11.18x | $474.29 | $25.3K | 543 | 5 |
| 2020 | $544.96 | $49.36 | 11.04x | $495.60 | $22.3K | 452 | 6 |
| 2021 | $405.91 | $304.75 | 1.33x | $101.16 | $1.2M | 4.0K | 15 |
| 2022 | $208.05 | $142.18 | 1.46x | $65.87 | $3.6M | 25.2K | 22 |
| 2023 | $56.71 | $40.54 | 1.40x | $16.17 | $3.9M | 95.9K | 19 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 5.7K | $4.1M | $717.87 | 1.29x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 103.9K | $3.0M | $29.22 | 1.39x |
| 67028 | Injection of drug into eye | 4.6K | $492.5K | $106.37 | 2.56x |
| J3590 | Unclassified biologics | 152 | $284.7K | $1.9K | 2.24x |
| 92134 | Imaging of retina | 7.3K | $233.2K | $32.17 | 2.57x |
| J2778 | Injection, ranibizumab, 0.1 mg | 580 | $138.4K | $238.65 | 1.36x |
| 92014 | Established patient complete exam of visual system | 1.2K | $97.4K | $82.08 | 4.87x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 611 | $60.8K | $99.56 | 1.54x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 57 | $42.8K | $751.57 | 3.46x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 224 | $35.1K | $156.91 | 1.45x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 262 | $33.2K | $126.75 | 1.53x |
| 92012 | Established patient problem focused exam of visual system | 433 | $32.4K | $74.93 | 1.81x |
| 92004 | New patient complete exam of visual system | 255 | $29.1K | $114.27 | 1.86x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 421 | $26.9K | $63.81 | 1.68x |
| J7999 | Compounded drug, not otherwise classified | 334 | $24.2K | $72.50 | 2.76x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 29 | $22.1K | $762.85 | 1.50x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 99 | $17.8K | $179.32 | 1.38x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 132 | $14.8K | $111.75 | 1.40x |
| 67210 | Destruction of growth of retina using a laser | 27 | $13.8K | $512.87 | 4.14x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 83 | $12.0K | $144.40 | 1.40x |
This provider submits charges 1.53 times higher than what Medicare actually pays.
A markup ratio of 1.53x means for every $100 Medicare pays, this provider initially charges $153. 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 CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Nathan Steinle, M.D. | Santa Barbara, CA | $63.1M | ✓ Clear |
| Stephen Couvillion, MD | Santa Barbara, CA | $47.7M | ✓ Clear |
| Margaret Chang, M.D. | Sacramento, CA | $47.6M | ✓ Clear |
| David Boyer, MD | Los Angeles, CA | $47.5M | ✓ Clear |
| Alessandro Castellarin, M.D. | Santa Barbara, CA | $46.9M | ✓ 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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