This provider averages 130 services per working day
Based on 324.9K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $40.7M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 130 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 | $444.58 | $160.49 | 2.77x | $284.09 | $3.8M | 23.9K | 24 |
| 2015 | $458.47 | $157.38 | 2.91x | $301.09 | $3.8M | 24.3K | 26 |
| 2016 | $488.35 | $167.89 | 2.91x | $320.46 | $4.3M | 25.4K | 22 |
| 2017 | $528.21 | $171.69 | 3.08x | $356.52 | $3.7M | 21.5K | 23 |
| 2018 | $561.80 | $185.16 | 3.03x | $376.64 | $4.2M | 22.8K | 22 |
| 2019 | $602.07 | $196.86 | 3.06x | $405.21 | $4.5M | 22.7K | 22 |
| 2020 | $590.97 | $226.20 | 2.61x | $364.77 | $4.2M | 18.6K | 22 |
| 2021 | $556.40 | $222.47 | 2.50x | $333.93 | $4.1M | 18.4K | 23 |
| 2022 | $322.97 | $101.46 | 3.18x | $221.51 | $3.9M | 38.3K | 24 |
| 2023 | $97.71 | $38.26 | 2.55x | $59.45 | $4.2M | 108.9K | 25 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 31.1K | $23.0M | $739.55 | 2.47x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 117.3K | $3.4M | $29.07 | 2.06x |
| J2778 | Injection, ranibizumab, 0.1 mg | 11.2K | $3.3M | $293.71 | 2.00x |
| 67028 | Injection of drug into eye | 22.1K | $1.7M | $78.66 | 7.42x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 15.5K | $1.3M | $86.44 | 2.02x |
| 92134 | Imaging of retina | 36.7K | $1.1M | $29.73 | 6.70x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 889 | $794.7K | $893.88 | 3.02x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 10.3K | $736.4K | $71.23 | 2.80x |
| 92240 | Examination of eye using an endoscope | 4.3K | $694.2K | $161.55 | 2.82x |
| J3590 | Unclassified biologics | 312 | $551.8K | $1.8K | 6.79x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 30.0K | $544.0K | $18.15 | 4.66x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 5.6K | $501.5K | $89.22 | 2.77x |
| 92242 | Exam of retinal blood vessels and blood vessels between the white part of eye and retina using a special camera after injection of a dye | 2.7K | $430.1K | $162.12 | 2.87x |
| 67210 | Destruction of growth of retina using a laser | 950 | $356.1K | $374.88 | 3.00x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 5.0K | $319.3K | $63.99 | 1.84x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 1.7K | $265.6K | $156.12 | 3.20x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.9K | $215.6K | $115.04 | 2.23x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 1.4K | $162.5K | $120.36 | 1.66x |
| 92201 | Extended exam of the back part of the eye with retinal drawing | 7.7K | $140.2K | $18.13 | 3.31x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 371 | $137.8K | $371.36 | 3.71x |
This provider submits charges 2.86 times higher than what Medicare actually pays.
A markup ratio of 2.86x means for every $100 Medicare pays, this provider initially charges $286. 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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