This provider averages 103 services per working day
Based on 256.5K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $16.5M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 103 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 58% 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 | $916.90 | $204.88 | 4.48x | $712.02 | $980.2K | 12.6K | 5.2K |
| 2015 | $553.67 | $130.51 | 4.24x | $423.16 | $1.1M | 14.8K | 6.3K |
| 2016 | $614.01 | $126.70 | 4.85x | $487.31 | $1.2M | 18.7K | 7.2K |
| 2017 | $695.14 | $137.01 | 5.07x | $558.13 | $1.4M | 23.6K | 9.7K |
| 2018 | $886.28 | $186.66 | 4.75x | $699.62 | $2.0M | 33.5K | 11.6K |
| 2019 | $758.87 | $152.40 | 4.98x | $606.47 | $2.3M | 39.3K | 10.6K |
| 2020 | $762.55 | $154.13 | 4.95x | $608.42 | $2.1M | 34.5K | 9.4K |
| 2021 | $676.43 | $132.41 | 5.11x | $544.02 | $2.2M | 33.0K | 9.1K |
| 2022 | $550.12 | $111.90 | 4.92x | $438.22 | $1.6M | 24.4K | 7.4K |
| 2023 | $544.99 | $106.66 | 5.11x | $438.33 | $1.6M | 22.1K | 7.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 41.8K | $3.7M | $88.35 | 2.30x |
| 67028 | Injection of drug into eye | 29.5K | $2.4M | $82.74 | 6.93x |
| 92134 | Diagnostic imaging of retina | 47.3K | $1.4M | $30.06 | 7.25x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 16.4K | $1.3M | $77.01 | 5.08x |
| J9035 | Injection, bevacizumab, 10 mg | 16.9K | $992.4K | $58.71 | 4.51x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 2.1K | $812.2K | $392.76 | 5.85x |
| J0178 | Injection, aflibercept, 1 mg | 1.1K | $772.9K | $722.31 | 3.49x |
| J7999 | Compounded drug, not otherwise classified | 11.2K | $749.3K | $67.06 | 4.48x |
| 92240 | Examination of eye using an endoscope | 3.7K | $581.3K | $157.45 | 2.67x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.6K | $553.4K | $83.99 | 2.53x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 8.1K | $517.5K | $64.25 | 1.93x |
| 92250 | Photography of the retina | 13.9K | $515.9K | $37.21 | 3.47x |
| 83861 | Microfluid analysis of tears | 17.0K | $376.9K | $22.17 | 2.12x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 16.0K | $299.8K | $18.77 | 3.62x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 767 | $276.1K | $359.96 | 6.27x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 2.9K | $184.1K | $63.04 | 2.36x |
| 67220 | Destruction of vascular growth between retina and sclera, 1 or more sessions | 415 | $170.3K | $410.43 | 5.60x |
| 92201 | Extended examination of eye with drawing of retina | 7.4K | $136.5K | $18.45 | 4.33x |
| 68761 | Closure of tear duct opening using plug | 967 | $115.0K | $118.96 | 4.68x |
| 92083 | Measurement of field of vision during daylight conditions | 2.2K | $99.1K | $45.06 | 2.59x |
This provider submits charges 4.37 times higher than what Medicare actually pays.
A markup ratio of 4.37x means for every $100 Medicare pays, this provider initially charges $437. 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 PA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Richard Kaiser, MD | Plymouth Meeting, PA | $75.2M | ✓ Clear |
| Allen Ho, MD | Plymouth Meeting, PA | $67.7M | ✓ Clear |
| Carl Regillo, MD | Plymouth Meeting, PA | $63.5M | ✓ Clear |
| Marc Spirn, MD | Plymouth Meeting, PA | $63.4M | ✓ Clear |
| Mitchell Fineman, MD | Plymouth Meeting, PA | $61.7M | ✓ 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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