This provider's $5.9M in total Medicare payments ranks in the 97th percentile of Ophthalmology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $761.90 | $212.49 | 3.59x | $549.41 | $733.7K | 12.4K | 9.8K |
| 2015 | $712.73 | $202.82 | 3.51x | $509.91 | $651.6K | 11.2K | 9.0K |
| 2016 | $621.67 | $177.89 | 3.49x | $443.78 | $620.5K | 11.4K | 9.1K |
| 2017 | $703.17 | $191.70 | 3.67x | $511.47 | $593.2K | 12.4K | 10.3K |
| 2018 | $781.28 | $206.78 | 3.78x | $574.50 | $628.6K | 11.0K | 8.6K |
| 2019 | $761.15 | $189.62 | 4.01x | $571.53 | $713.0K | 13.1K | 10.6K |
| 2020 | $892.05 | $189.22 | 4.71x | $702.83 | $479.0K | 8.4K | 7.2K |
| 2021 | $1.0K | $228.71 | 4.45x | $789.56 | $570.5K | 8.7K | 7.1K |
| 2022 | $1.1K | $230.30 | 4.99x | $919.39 | $428.6K | 6.8K | 5.8K |
| 2023 | $984.66 | $188.91 | 5.21x | $795.75 | $454.8K | 7.6K | 6.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 12.7K | $1.0M | $81.41 | 1.72x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 16.8K | $953.7K | $56.87 | 1.77x |
| 92083 | Measurement of field of vision during daylight conditions | 14.1K | $600.7K | $42.46 | 2.35x |
| 92133 | Diagnostic imaging of optic nerve of eye | 19.9K | $535.5K | $26.94 | 3.71x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.4K | $372.9K | $84.09 | 2.30x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.5K | $318.8K | $58.28 | 2.44x |
| 92020 | Examination of cornea and iris using lens device and slit lamp | 14.4K | $274.1K | $18.99 | 2.90x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 1.1K | $188.9K | $165.86 | 7.24x |
| 66984 | Removal of cataract with insertion of lens | 499 | $180.8K | $362.38 | 6.48x |
| 66180 | Creation of shunt to improve eye fluid flow | 204 | $175.8K | $861.62 | 2.52x |
| 66761 | Creation of eye fluid drainage tracts in iris using laser, per session | 775 | $169.1K | $218.25 | 5.96x |
| 92250 | Photography of the retina | 3.5K | $167.3K | $47.28 | 1.71x |
| 66170 | Creation of eye fluid drainage tract | 158 | $135.4K | $856.95 | 2.22x |
| 0449T | Insertion of aqueous fluid drainage device into eye | 158 | $94.3K | $597.10 | 4.02x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 159 | $80.2K | $504.71 | 8.77x |
| 66711 | Destruction of tissue encircling lens using en endoscope | 180 | $65.0K | $361.37 | 2.28x |
| 66982 | Removal of cataract with insertion of lens | 117 | $62.8K | $536.71 | 4.38x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 571 | $55.8K | $97.78 | 1.69x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 222 | $54.9K | $247.25 | 4.04x |
| 66988 | Removal of cataract with insertion of lens and laser treatment to decrease fluid production in eye | 94 | $52.3K | $556.26 | 5.39x |
This provider submits charges 2.97 times higher than what Medicare actually pays.
A markup ratio of 2.97x means for every $100 Medicare pays, this provider initially charges $297. 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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