This provider's $9.4M in total Medicare payments ranks in the 98th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 406% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 197% 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 | $228.51 | $151.12 | 1.51x | $77.39 | $223.3K | 2.0K | 1.3K |
| 2015 | $214.39 | $142.00 | 1.51x | $72.39 | $662.5K | 5.3K | 3.2K |
| 2016 | $209.97 | $140.92 | 1.49x | $69.05 | $763.7K | 5.9K | 3.4K |
| 2017 | $207.59 | $138.53 | 1.50x | $69.06 | $886.4K | 6.4K | 3.7K |
| 2018 | $202.22 | $133.89 | 1.51x | $68.33 | $1.1M | 7.8K | 4.4K |
| 2019 | $412.82 | $146.07 | 2.83x | $266.75 | $1.2M | 8.3K | 4.5K |
| 2020 | $482.39 | $139.89 | 3.45x | $342.50 | $1.1M | 7.8K | 4.2K |
| 2021 | $425.02 | $138.12 | 3.08x | $286.90 | $1.1M | 8.3K | 4.5K |
| 2022 | $559.90 | $162.11 | 3.45x | $397.79 | $1.2M | 8.5K | 4.1K |
| 2023 | $450.85 | $131.30 | 3.43x | $319.55 | $1.1M | 8.0K | 3.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 4.7K | $3.5M | $732.13 | 1.54x |
| 66984 | Removal of cataract with insertion of lens | 4.7K | $1.8M | $383.50 | 2.27x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 9.5K | $770.8K | $81.12 | 2.54x |
| 67028 | Injection of drug into eye | 8.1K | $755.3K | $92.78 | 4.23x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 7.2K | $403.7K | $56.42 | 1.87x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.8K | $386.8K | $101.05 | 2.57x |
| 92134 | Diagnostic imaging of retina | 10.9K | $353.3K | $32.38 | 2.56x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 3.6K | $335.6K | $94.15 | 2.56x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 799 | $199.1K | $249.14 | 2.28x |
| J7999 | Compounded drug, not otherwise classified | 2.9K | $187.3K | $64.96 | 3.83x |
| 92136 | Measurement of corneal curvature and depth of eye | 4.3K | $171.5K | $40.34 | 2.91x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 2.0K | $125.4K | $61.23 | 2.24x |
| 66982 | Removal of cataract with insertion of lens | 179 | $103.3K | $576.87 | 2.47x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 700 | $80.5K | $115.03 | 2.96x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 246 | $56.8K | $231.06 | 1.93x |
| 92133 | Diagnostic imaging of optic nerve of eye | 1.5K | $41.4K | $26.94 | 2.90x |
| 92083 | Measurement of field of vision during daylight conditions | 749 | $31.6K | $42.14 | 2.57x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 60 | $27.7K | $461.38 | 6.09x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 185 | $14.2K | $76.63 | 2.06x |
| J9035 | Injection, bevacizumab, 10 mg | 261 | $13.5K | $51.77 | 2.03x |
This provider submits charges 2.27 times higher than what Medicare actually pays.
A markup ratio of 2.27x means for every $100 Medicare pays, this provider initially charges $227. 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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