This provider averages 76 services per working day
Based on 190.2K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $11.7M in total Medicare payments ranks in the 98th percentile of Ophthalmology providers nationally.
Averaging 76 services per working day raises questions about billing patterns.
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 | $281.66 | $141.43 | 1.99x | $140.23 | $1.2M | 20.7K | 8.8K |
| 2015 | $395.06 | $191.47 | 2.06x | $203.59 | $1.2M | 19.0K | 8.0K |
| 2016 | $288.04 | $132.55 | 2.17x | $155.49 | $1.3M | 21.1K | 8.2K |
| 2017 | $353.92 | $173.09 | 2.04x | $180.83 | $1.2M | 21.5K | 8.1K |
| 2018 | $354.61 | $177.43 | 2.00x | $177.18 | $1.2M | 21.1K | 7.7K |
| 2019 | $277.75 | $111.95 | 2.48x | $165.80 | $1.2M | 18.6K | 6.7K |
| 2020 | $302.44 | $119.68 | 2.53x | $182.76 | $1.1M | 16.7K | 6.2K |
| 2021 | $274.77 | $123.83 | 2.22x | $150.94 | $1.2M | 17.8K | 6.7K |
| 2022 | $266.97 | $112.92 | 2.36x | $154.05 | $1.1M | 17.0K | 6.3K |
| 2023 | $269.14 | $110.44 | 2.44x | $158.70 | $1.1M | 16.7K | 6.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 67028 | Injection of drug into eye | 37.7K | $3.3M | $88.44 | 1.73x |
| J9035 | Injection, bevacizumab, 10 mg | 36.1K | $1.8M | $48.56 | 1.53x |
| 92134 | Diagnostic imaging of retina | 47.2K | $1.7M | $36.02 | 1.54x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 12.9K | $1.3M | $101.40 | 1.45x |
| J0178 | Injection, aflibercept, 1 mg | 1.2K | $800.2K | $693.44 | 3.61x |
| 99214 | Established patient outpatient visit, total time 30-39 minutes | 3.9K | $418.9K | $106.16 | 1.37x |
| 92250 | Photography of the retina | 7.1K | $378.3K | $52.99 | 1.40x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 16.0K | $348.8K | $21.79 | 1.44x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 4.7K | $343.1K | $72.82 | 1.39x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 3.0K | $276.6K | $93.22 | 1.37x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.5K | $250.5K | $70.81 | 1.33x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 1.9K | $224.1K | $121.02 | 1.46x |
| 92201 | Extended examination of eye with drawing of retina | 8.9K | $191.6K | $21.53 | 1.50x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 612 | $83.8K | $136.92 | 1.40x |
| 76512 | Ultrasound of eye disease, growth, or structure | 1.4K | $83.2K | $58.99 | 1.59x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 1.8K | $70.0K | $38.46 | 1.28x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 1.8K | $43.2K | $23.76 | 1.44x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 25 | $25.7K | $1.0K | 1.31x |
| 67145 | Preventive retinal detachment treatment by heat or laser, 1 or more sessions | 38 | $17.5K | $459.41 | 1.58x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 13 | $10.7K | $823.68 | 1.77x |
This provider submits charges 1.69 times higher than what Medicare actually pays.
A markup ratio of 1.69x means for every $100 Medicare pays, this provider initially charges $169. 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 NJ for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Howard Fine, MD MHSC | New Brunswick, NJ | $44.5M | ✓ Clear |
| Robert Barone, MD | Newton, NJ | $43.3M | ✓ Clear |
| Jonathan Prenner, MD | New Brunswick, NJ | $43.1M | ✓ Clear |
| Sumit Shah, M.D. | New Brunswick, NJ | $37.0M | ✓ Clear |
| David Kim, M.D. | Union, NJ | $36.1M | ✓ 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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