This provider averages 76 services per working day
Based on 190.7K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $37.6M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 76 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 102% from 2014 to 2023.
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 | $314.67 | $204.12 | 1.54x | $110.55 | $2.1M | 10.2K | 18 |
| 2015 | $328.24 | $216.07 | 1.52x | $112.17 | $3.1M | 14.3K | 17 |
| 2016 | $347.31 | $223.84 | 1.55x | $123.47 | $3.3M | 14.9K | 18 |
| 2017 | $361.80 | $233.77 | 1.55x | $128.03 | $3.8M | 16.4K | 18 |
| 2018 | $376.23 | $244.73 | 1.54x | $131.50 | $4.2M | 17.3K | 17 |
| 2019 | $389.40 | $249.47 | 1.56x | $139.93 | $4.6M | 18.4K | 19 |
| 2020 | $401.72 | $258.68 | 1.55x | $143.04 | $4.1M | 15.7K | 16 |
| 2021 | $420.10 | $268.48 | 1.56x | $151.62 | $4.3M | 15.9K | 17 |
| 2022 | $321.69 | $202.32 | 1.59x | $119.37 | $4.0M | 19.6K | 18 |
| 2023 | $145.59 | $87.55 | 1.66x | $58.04 | $4.2M | 48.1K | 18 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 26.6K | $19.6M | $737.24 | 1.36x |
| J2778 | Injection, ranibizumab, 0.1 mg | 35.8K | $10.3M | $286.75 | 1.47x |
| 67028 | Injection of drug into eye | 20.5K | $1.9M | $92.37 | 2.70x |
| 92014 | Established patient complete exam of visual system | 14.2K | $1.4M | $97.70 | 1.54x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 40.3K | $1.2M | $29.23 | 1.51x |
| 92134 | Imaging of retina | 29.9K | $1.0M | $33.62 | 3.09x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 6.9K | $474.2K | $68.95 | 1.48x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 2.8K | $369.8K | $130.02 | 1.63x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 2.4K | $202.3K | $84.90 | 2.60x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 2.5K | $177.9K | $72.39 | 1.64x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 172 | $174.6K | $1.0K | 3.74x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 1.7K | $161.5K | $92.74 | 1.78x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 210 | $156.4K | $744.84 | 4.15x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 528 | $132.4K | $250.85 | 1.46x |
| J3590 | Unclassified biologics | 74 | $131.3K | $1.8K | 1.55x |
| 92250 | Photography of the retina | 1.9K | $97.7K | $51.03 | 2.49x |
| J9035 | Injection, bevacizumab, 10 mg | 961 | $54.1K | $56.30 | 1.78x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 106 | $30.0K | $283.03 | 5.16x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 114 | $19.9K | $174.89 | 1.53x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 957 | $19.2K | $20.11 | 3.73x |
This provider submits charges 1.57 times higher than what Medicare actually pays.
A markup ratio of 1.57x means for every $100 Medicare pays, this provider initially charges $157. This is lower 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 MD for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Michael Elman, M.D. | Baltimore, MD | $68.5M | ✓ Clear |
| David Warrow, M.D. | Hagerstown, MD | $65.5M | ✓ Clear |
| Raymond Sjaarda, M.D. | Baltimore, MD | $47.2M | ✓ Clear |
| Allen Hu, MD | Hagerstown, MD | $45.7M | ✓ Clear |
| James Rial, M.D. | Salisbury, MD | $45.2M | ✓ 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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