This provider's $4.0M in total Medicare payments ranks in the 95th percentile of Ophthalmology providers nationally.
Their average markup ratio of 6.21x is significantly above the specialty median of 2.9x.
Medicare payments to this provider grew 915% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 468% in 2015
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 | $939.39 | $222.64 | 4.22x | $716.75 | $40.1K | 224 | 175 |
| 2015 | $937.94 | $136.92 | 6.85x | $801.02 | $227.5K | 1.6K | 1.3K |
| 2016 | $857.39 | $129.64 | 6.61x | $727.75 | $342.4K | 2.8K | 2.2K |
| 2017 | $923.22 | $150.20 | 6.15x | $773.02 | $445.9K | 3.7K | 2.7K |
| 2018 | $1.1K | $178.00 | 6.01x | $891.93 | $522.5K | 4.1K | 3.1K |
| 2019 | $1.2K | $190.51 | 6.44x | $1.0K | $567.6K | 4.2K | 3.1K |
| 2020 | $1.1K | $189.96 | 5.70x | $891.94 | $477.8K | 3.9K | 2.8K |
| 2021 | $1.3K | $181.25 | 7.03x | $1.1K | $486.5K | 3.8K | 2.6K |
| 2022 | $1.3K | $202.73 | 6.63x | $1.1K | $514.1K | 3.9K | 2.7K |
| 2023 | $1.0K | $166.92 | 6.18x | $865.33 | $406.7K | 3.6K | 2.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 1.5K | $713.0K | $483.74 | 10.65x |
| J0178 | Injection, aflibercept, 1 mg | 960 | $686.0K | $714.60 | 3.08x |
| 66982 | Removal of cataract with insertion of lens | 883 | $563.9K | $638.59 | 9.02x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 5.9K | $465.0K | $79.14 | 2.91x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 1.4K | $420.9K | $293.32 | 6.36x |
| 92250 | Photography of the retina | 5.3K | $187.1K | $35.39 | 5.38x |
| 67028 | Injection of drug into eye | 1.7K | $153.2K | $87.88 | 9.77x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 1.8K | $119.0K | $67.64 | 2.40x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 1.2K | $108.8K | $87.78 | 3.17x |
| 92136 | Measurement of corneal curvature and depth of eye | 2.4K | $104.5K | $44.37 | 6.42x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 99 | $68.5K | $691.52 | 5.18x |
| 92134 | Diagnostic imaging of retina | 2.1K | $67.7K | $32.20 | 4.73x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 562 | $54.1K | $96.33 | 4.58x |
| 66711 | Destruction of tissue encircling lens using en endoscope | 136 | $53.3K | $391.64 | 5.11x |
| 92025 | Computerized mapping of corneal curvature | 1.8K | $52.6K | $28.89 | 4.47x |
| J7999 | Compounded drug, not otherwise classified | 656 | $37.4K | $57.08 | 1.35x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 58 | $25.9K | $446.51 | 5.44x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 181 | $25.8K | $142.68 | 3.98x |
| 92083 | Measurement of field of vision during daylight conditions | 514 | $23.0K | $44.79 | 4.39x |
| 92133 | Diagnostic imaging of optic nerve of eye | 753 | $21.1K | $28.02 | 5.53x |
This provider submits charges 6.21 times higher than what Medicare actually pays.
A markup ratio of 6.21x means for every $100 Medicare pays, this provider initially charges $621. This is higher than the national average.
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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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