This provider averages 84 services per working day
Based on 209.6K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $38.7M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 84 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 52% 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 | $582.07 | $187.53 | 3.10x | $394.54 | $2.7M | 14.2K | 17 |
| 2015 | $615.45 | $201.39 | 3.06x | $414.06 | $3.6M | 17.7K | 17 |
| 2016 | $609.45 | $201.51 | 3.02x | $407.94 | $3.9M | 19.4K | 19 |
| 2017 | $605.44 | $197.73 | 3.06x | $407.71 | $4.1M | 20.6K | 18 |
| 2018 | $556.56 | $175.62 | 3.17x | $380.94 | $4.4M | 24.8K | 17 |
| 2019 | $608.36 | $186.72 | 3.26x | $421.64 | $4.6M | 24.7K | 17 |
| 2020 | $668.76 | $203.35 | 3.29x | $465.41 | $3.8M | 18.8K | 15 |
| 2021 | $660.56 | $197.38 | 3.35x | $463.18 | $3.9M | 19.5K | 19 |
| 2022 | $655.72 | $189.82 | 3.45x | $465.90 | $3.8M | 20.1K | 21 |
| 2023 | $453.43 | $136.04 | 3.33x | $317.39 | $4.0M | 29.7K | 23 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2778 | Injection, ranibizumab, 0.1 mg | 54.3K | $14.9M | $274.92 | 2.91x |
| J0178 | Injection, aflibercept, 1 mg | 19.9K | $14.7M | $735.82 | 2.76x |
| 67028 | Injection of drug into eye | 21.5K | $2.2M | $101.21 | 6.90x |
| 92012 | Established patient problem focused exam of visual system | 18.4K | $1.4M | $76.53 | 2.66x |
| 92134 | Imaging of retina | 36.7K | $1.4M | $37.73 | 4.51x |
| 92014 | Established patient complete exam of visual system | 6.5K | $675.3K | $103.96 | 3.40x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 15.1K | $495.6K | $32.92 | 3.81x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 13.0K | $376.0K | $28.88 | 2.42x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 1.7K | $371.7K | $216.88 | 3.69x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 2.3K | $323.2K | $143.54 | 2.59x |
| J3490 | Unclassified drugs | 149 | $285.6K | $1.9K | 2.17x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 3.4K | $266.7K | $79.57 | 3.77x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 1.6K | $204.6K | $125.07 | 2.79x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 232 | $162.8K | $701.68 | 9.26x |
| J9035 | Injection, bevacizumab, 10 mg | 2.7K | $151.2K | $56.22 | 6.43x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 1.0K | $122.8K | $118.62 | 2.49x |
| 67041 | Removal of membrane from the retina | 90 | $94.3K | $1.0K | 6.20x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 595 | $84.4K | $141.91 | 3.52x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 2.0K | $81.5K | $41.41 | 3.69x |
| 92201 | Extended exam of the back part of the eye with retinal drawing | 3.3K | $71.9K | $21.80 | 4.13x |
This provider submits charges 3.21 times higher than what Medicare actually pays.
A markup ratio of 3.21x means for every $100 Medicare pays, this provider initially charges $321. 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 NY for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Jonathan Jonisch, MD | Great Neck, NY | $52.3M | ✓ Clear |
| Jeffrey Josef, M.D. | Suffern, NY | $52.2M | ✓ Clear |
| Brett Rosenblatt | Great Neck, NY | $50.0M | ✓ Clear |
| Kenneth Graham | Great Neck, NY | $47.1M | ✓ Clear |
| Glenn Stoller, M.D. | Rockville Centre, NY | $46.4M | ✓ 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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