This provider averages 81 services per working day
Based on 202.5K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $34.7M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 81 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 42790% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 18658% in 2016
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 | $702.09 | $71.04 | 9.88x | $631.05 | $16.3K | 230 | 4 |
| 2015 | $480.00 | $75.16 | 6.39x | $404.84 | $5.0K | 66 | 1 |
| 2016 | $659.88 | $210.08 | 3.14x | $449.80 | $930.5K | 4.4K | 14 |
| 2017 | $733.43 | $222.55 | 3.30x | $510.88 | $3.5M | 15.6K | 20 |
| 2018 | $661.43 | $203.10 | 3.26x | $458.33 | $4.0M | 19.7K | 21 |
| 2019 | $694.14 | $204.82 | 3.39x | $489.32 | $4.1M | 20.1K | 21 |
| 2020 | $780.75 | $222.53 | 3.51x | $558.22 | $4.2M | 19.0K | 20 |
| 2021 | $757.09 | $214.63 | 3.53x | $542.46 | $5.1M | 23.9K | 18 |
| 2022 | $697.55 | $191.57 | 3.64x | $505.98 | $5.8M | 30.4K | 17 |
| 2023 | $363.36 | $101.45 | 3.58x | $261.91 | $7.0M | 69.1K | 22 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2778 | Injection, ranibizumab, 0.1 mg | 54.8K | $14.5M | $264.85 | 3.40x |
| J0178 | Injection, aflibercept, 1 mg | 16.6K | $12.0M | $718.65 | 3.39x |
| 67028 | Injection of drug into eye | 18.3K | $1.9M | $101.10 | 4.63x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 47.5K | $1.4M | $29.23 | 2.50x |
| 92012 | Established patient problem focused exam of visual system | 16.9K | $1.2M | $71.14 | 2.68x |
| 92134 | Imaging of retina | 27.4K | $926.6K | $33.78 | 4.29x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 2.6K | $571.5K | $215.76 | 3.71x |
| 92014 | Established patient complete exam of visual system | 4.8K | $469.7K | $98.68 | 2.95x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 3.0K | $391.6K | $130.49 | 2.66x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 1.7K | $202.2K | $120.36 | 3.87x |
| J3590 | Unclassified biologics | 98 | $200.1K | $2.0K | 3.06x |
| J3490 | Unclassified drugs | 111 | $196.4K | $1.8K | 3.79x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 99 | $98.6K | $995.57 | 6.87x |
| 67113 | Complex repair of detached retina and drainage of eye fluid between lens and retina | 87 | $95.7K | $1.1K | 6.75x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 99 | $95.7K | $966.91 | 6.33x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 213 | $84.9K | $398.37 | 5.62x |
| 92201 | Extended exam of the back part of the eye with retinal drawing | 4.1K | $81.0K | $19.94 | 4.26x |
| 67039 | Destruction of eye fluid (vitreous) between lens and retina using a laser | 83 | $67.7K | $815.99 | 6.61x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 378 | $56.1K | $148.43 | 3.37x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 148 | $44.8K | $302.72 | 15.63x |
This provider submits charges 3.48 times higher than what Medicare actually pays.
A markup ratio of 3.48x means for every $100 Medicare pays, this provider initially charges $348. 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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