This provider averages 99 services per working day
Based on 247.3K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $38.6M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 99 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 | $247.19 | $115.77 | 2.14x | $131.42 | $3.3M | 28.9K | 18 |
| 2015 | $258.05 | $118.45 | 2.18x | $139.60 | $4.1M | 34.6K | 19 |
| 2016 | $294.72 | $137.11 | 2.15x | $157.61 | $4.7M | 34.2K | 15 |
| 2017 | $317.75 | $147.49 | 2.15x | $170.26 | $5.0M | 33.8K | 12 |
| 2018 | $352.17 | $163.37 | 2.16x | $188.80 | $5.0M | 30.5K | 13 |
| 2019 | $374.82 | $181.64 | 2.06x | $193.18 | $4.1M | 22.8K | 13 |
| 2020 | $440.51 | $212.86 | 2.07x | $227.65 | $3.0M | 13.9K | 12 |
| 2021 | $413.07 | $198.04 | 2.09x | $215.03 | $3.0M | 15.4K | 10 |
| 2022 | $402.09 | $187.06 | 2.15x | $215.03 | $2.9M | 15.5K | 13 |
| 2023 | $399.00 | $194.89 | 2.05x | $204.11 | $3.4M | 17.7K | 15 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 23.2K | $17.2M | $740.16 | 1.69x |
| J2778 | Injection, ranibizumab, 0.1 mg | 32.2K | $9.7M | $302.51 | 1.65x |
| 92014 | Established patient complete exam of visual system | 25.4K | $2.7M | $104.27 | 2.45x |
| 76512 | 2d ultrasound scan of eye tissue and structures | 28.4K | $1.8M | $63.96 | 3.28x |
| 67028 | Injection of drug into eye | 18.5K | $1.7M | $92.08 | 4.85x |
| 92134 | Imaging of retina | 36.3K | $1.3M | $36.60 | 2.87x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 38.4K | $838.9K | $21.82 | 2.29x |
| 92250 | Photography of the retina | 11.9K | $662.1K | $55.61 | 3.06x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 5.2K | $525.9K | $100.89 | 2.97x |
| J3490 | Unclassified drugs | 290 | $512.9K | $1.8K | 1.41x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 4.1K | $435.2K | $105.96 | 2.12x |
| 67515 | Injection of medication or substance into membrane covering eyeball | 10.2K | $426.7K | $41.94 | 8.35x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 2.4K | $292.7K | $120.36 | 1.39x |
| 92201 | Extended exam of the back part of the eye with retinal drawing | 5.0K | $105.8K | $21.36 | 2.34x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 799 | $102.8K | $128.66 | 2.72x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 1.1K | $86.0K | $75.78 | 2.31x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 566 | $70.0K | $123.63 | 2.43x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 704 | $55.1K | $78.24 | 1.92x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 67 | $30.4K | $453.74 | 3.15x |
| J9035 | Injection, bevacizumab, 10 mg | 456 | $24.4K | $53.57 | 3.27x |
This provider submits charges 2.12 times higher than what Medicare actually pays.
A markup ratio of 2.12x means for every $100 Medicare pays, this provider initially charges $212. 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 CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Nathan Steinle, M.D. | Santa Barbara, CA | $63.1M | ✓ Clear |
| Stephen Couvillion, MD | Santa Barbara, CA | $47.7M | ✓ Clear |
| Margaret Chang, M.D. | Sacramento, CA | $47.6M | ✓ Clear |
| David Boyer, MD | Los Angeles, CA | $47.5M | ✓ Clear |
| Alessandro Castellarin, M.D. | Santa Barbara, CA | $46.9M | ✓ 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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