This provider averages 72 services per working day
Based on 181.1K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $32.6M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 72 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 274% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 72% in 2020
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 | $345.01 | $137.06 | 2.52x | $207.95 | $1.6M | 11.6K | 22 |
| 2015 | $351.25 | $146.41 | 2.40x | $204.84 | $1.7M | 11.8K | 23 |
| 2016 | $343.18 | $142.88 | 2.40x | $200.30 | $2.2M | 15.7K | 23 |
| 2017 | $350.49 | $144.25 | 2.43x | $206.24 | $1.9M | 13.4K | 21 |
| 2018 | $362.34 | $147.82 | 2.45x | $214.52 | $2.0M | 13.3K | 20 |
| 2019 | $418.11 | $167.22 | 2.50x | $250.89 | $2.6M | 15.7K | 20 |
| 2020 | $653.94 | $254.95 | 2.56x | $398.99 | $4.5M | 17.7K | 21 |
| 2021 | $705.21 | $270.01 | 2.61x | $435.20 | $4.9M | 18.0K | 20 |
| 2022 | $579.11 | $214.29 | 2.70x | $364.82 | $5.2M | 24.1K | 20 |
| 2023 | $393.92 | $149.31 | 2.64x | $244.61 | $6.0M | 39.9K | 22 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 25.5K | $18.6M | $728.11 | 2.56x |
| J2778 | Injection, ranibizumab, 0.1 mg | 18.7K | $5.1M | $273.18 | 2.21x |
| 67028 | Injection of drug into eye | 19.1K | $1.6M | $86.19 | 2.88x |
| 92134 | Imaging of retina | 25.5K | $755.4K | $29.62 | 2.88x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 24.8K | $726.3K | $29.31 | 2.55x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 9.0K | $685.7K | $76.49 | 2.76x |
| 92014 | Established patient complete exam of visual system | 7.8K | $648.5K | $83.10 | 2.87x |
| J3490 | Unclassified drugs | 311 | $550.0K | $1.8K | 2.65x |
| J3590 | Unclassified biologics | 4.7K | $492.6K | $105.53 | 2.89x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 1.7K | $428.7K | $249.85 | 2.50x |
| 92012 | Established patient problem focused exam of visual system | 6.6K | $405.2K | $61.65 | 2.75x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 3.2K | $390.0K | $120.36 | 2.56x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 5.1K | $376.5K | $74.27 | 2.98x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 277 | $256.7K | $926.56 | 2.57x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 11.2K | $199.9K | $17.81 | 2.19x |
| 92250 | Photography of the retina | 5.1K | $195.2K | $38.47 | 3.61x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 197 | $188.6K | $957.45 | 3.19x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 1.0K | $155.6K | $151.54 | 2.70x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.4K | $154.9K | $113.47 | 2.83x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 240 | $118.6K | $494.10 | 4.12x |
This provider submits charges 2.56 times higher than what Medicare actually pays.
A markup ratio of 2.56x means for every $100 Medicare pays, this provider initially charges $256. 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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