This provider averages 125 services per working day
Based on 312.5K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $35.4M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 125 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 122% 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 | $351.76 | $107.10 | 3.28x | $244.66 | $2.4M | 22.8K | 26 |
| 2015 | $430.56 | $136.05 | 3.16x | $294.51 | $3.1M | 23.0K | 22 |
| 2016 | $504.01 | $163.79 | 3.08x | $340.22 | $2.7M | 16.3K | 22 |
| 2017 | $503.53 | $169.40 | 2.97x | $334.13 | $2.3M | 13.9K | 23 |
| 2018 | $457.23 | $161.50 | 2.83x | $295.73 | $3.1M | 19.3K | 21 |
| 2019 | $496.89 | $179.64 | 2.77x | $317.25 | $3.6M | 19.9K | 18 |
| 2020 | $526.01 | $187.90 | 2.80x | $338.11 | $3.8M | 20.2K | 17 |
| 2021 | $521.72 | $188.43 | 2.77x | $333.29 | $4.2M | 22.3K | 21 |
| 2022 | $336.20 | $118.00 | 2.85x | $218.20 | $4.8M | 40.3K | 20 |
| 2023 | $137.98 | $47.27 | 2.92x | $90.71 | $5.4M | 114.6K | 17 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 24.5K | $18.2M | $741.63 | 2.29x |
| J2778 | Injection, ranibizumab, 0.1 mg | 14.5K | $3.9M | $267.49 | 2.24x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 115.3K | $3.4M | $29.25 | 2.56x |
| 67028 | Injection of drug into eye | 30.4K | $2.5M | $83.83 | 5.50x |
| 92014 | Established patient complete exam of visual system | 18.2K | $1.6M | $89.39 | 3.90x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 13.2K | $1.0M | $79.43 | 4.27x |
| 92134 | Imaging of retina | 27.0K | $838.1K | $31.02 | 4.50x |
| J7999 | Compounded drug, not otherwise classified | 10.6K | $694.3K | $65.48 | 4.58x |
| 92250 | Photography of the retina | 16.0K | $616.4K | $38.57 | 5.39x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 7.0K | $544.0K | $77.77 | 4.22x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 2.6K | $408.1K | $156.30 | 1.92x |
| J3590 | Unclassified biologics | 2.7K | $238.5K | $89.12 | 4.27x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 226 | $210.6K | $931.93 | 3.83x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 756 | $189.3K | $250.42 | 2.20x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 2.6K | $164.9K | $63.72 | 3.76x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 7.1K | $125.6K | $17.60 | 4.46x |
| J2997 | Injection, alteplase recombinant, 1 mg | 2.3K | $121.1K | $52.63 | 2.69x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.1K | $114.6K | $108.03 | 4.00x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1.7K | $113.2K | $65.56 | 3.41x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 761 | $79.0K | $103.79 | 3.66x |
This provider submits charges 2.92 times higher than what Medicare actually pays.
A markup ratio of 2.92x means for every $100 Medicare pays, this provider initially charges $292. 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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