This provider averages 122 services per working day
Based on 304.6K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $52.2M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 122 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 89% from 2014 to 2023.
68% of their billing comes from a single procedure code (J0178 — Injection, aflibercept, 1 mg).
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 | $389.06 | $174.75 | 2.23x | $214.31 | $3.0M | 16.9K | 18 |
| 2015 | $403.36 | $192.24 | 2.10x | $211.12 | $3.3M | 17.2K | 20 |
| 2016 | $452.60 | $217.34 | 2.08x | $235.26 | $4.2M | 19.4K | 17 |
| 2017 | $558.69 | $271.60 | 2.06x | $287.09 | $5.4M | 19.8K | 17 |
| 2018 | $610.32 | $294.97 | 2.07x | $315.35 | $6.4M | 21.6K | 14 |
| 2019 | $636.31 | $302.10 | 2.11x | $334.21 | $6.8M | 22.5K | 13 |
| 2020 | $699.73 | $334.64 | 2.09x | $365.09 | $6.0M | 17.8K | 12 |
| 2021 | $691.98 | $332.64 | 2.08x | $359.34 | $6.4M | 19.4K | 13 |
| 2022 | $537.98 | $250.15 | 2.15x | $287.83 | $5.1M | 20.5K | 17 |
| 2023 | $84.57 | $43.28 | 1.95x | $41.29 | $5.6M | 129.4K | 17 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 47.4K | $35.1M | $741.48 | 2.03x |
| J2778 | Injection, ranibizumab, 0.1 mg | 12.7K | $3.9M | $304.32 | 1.64x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 120.5K | $3.5M | $29.14 | 1.72x |
| 65800 | Removal of eye fluid | 24.1K | $2.7M | $112.02 | 2.67x |
| 92014 | Established patient complete exam of visual system | 14.1K | $1.6M | $110.71 | 1.80x |
| 92134 | Imaging of retina | 33.7K | $1.3M | $38.21 | 3.14x |
| 92012 | Established patient problem focused exam of visual system | 11.3K | $905.2K | $80.01 | 1.87x |
| 92242 | Exam of retinal blood vessels and blood vessels between the white part of eye and retina using a special camera after injection of a dye | 2.7K | $599.6K | $224.82 | 1.34x |
| 67028 | Injection of drug into eye | 6.6K | $581.9K | $87.56 | 4.00x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 13.3K | $282.8K | $21.18 | 4.25x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.8K | $259.2K | $144.16 | 1.73x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 2.6K | $251.0K | $94.91 | 1.84x |
| 67042 | Removal of membrane from the retina, pars plana approach | 170 | $192.6K | $1.1K | 4.41x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 1.5K | $180.5K | $120.36 | 1.66x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1.7K | $148.8K | $85.15 | 1.47x |
| 67031 | Release of scar tissue between lens and retina using a laser | 358 | $130.0K | $363.02 | 4.13x |
| J3490 | Unclassified drugs | 63 | $110.4K | $1.8K | 3.37x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 91 | $82.0K | $901.00 | 2.77x |
| 92201 | Extended exam of the back part of the eye with retinal drawing | 3.4K | $76.6K | $22.25 | 2.28x |
| 92250 | Photography of the retina | 1.2K | $71.9K | $60.55 | 2.89x |
This provider submits charges 2.08 times higher than what Medicare actually pays.
A markup ratio of 2.08x means for every $100 Medicare pays, this provider initially charges $208. 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 NY for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Jonathan Jonisch, MD | Great Neck, NY | $52.3M | ✓ Clear |
| Brett Rosenblatt | Great Neck, NY | $50.0M | ✓ Clear |
| Kenneth Graham | Great Neck, NY | $47.1M | ✓ Clear |
| Glenn Stoller, M.D. | Rockville Centre, NY | $46.4M | ✓ Clear |
| James Klancnik, MD | New York, NY | $44.0M | ✓ 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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