This provider's $3.8M in total Medicare payments ranks in the 95th percentile of Ophthalmology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $247.79 | $93.12 | 2.66x | $154.67 | $387.5K | 5.7K | 4.3K |
| 2015 | $235.10 | $81.61 | 2.88x | $153.49 | $379.3K | 5.8K | 4.5K |
| 2016 | $269.98 | $93.55 | 2.89x | $176.43 | $383.6K | 5.7K | 4.4K |
| 2017 | $281.47 | $80.75 | 3.49x | $200.72 | $237.9K | 4.2K | 3.5K |
| 2018 | $600.94 | $95.83 | 6.27x | $505.11 | $314.4K | 4.0K | 2.9K |
| 2019 | $735.82 | $87.80 | 8.38x | $648.02 | $430.6K | 6.2K | 4.5K |
| 2020 | $765.32 | $121.22 | 6.31x | $644.10 | $400.1K | 6.0K | 4.5K |
| 2021 | $729.73 | $88.25 | 8.27x | $641.48 | $347.9K | 6.5K | 4.8K |
| 2022 | $748.03 | $110.82 | 6.75x | $637.21 | $430.9K | 7.0K | 5.1K |
| 2023 | $738.47 | $100.92 | 7.32x | $637.55 | $443.5K | 8.0K | 5.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 10.9K | $697.7K | $63.93 | 4.48x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 5.5K | $544.0K | $98.07 | 2.39x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 6.2K | $435.9K | $70.49 | 2.66x |
| 92083 | Measurement of field of vision during daylight conditions | 8.5K | $357.7K | $41.84 | 4.91x |
| 92133 | Diagnostic imaging of optic nerve of eye | 8.3K | $268.2K | $32.29 | 4.61x |
| 92250 | Photography of the retina | 4.4K | $207.5K | $47.31 | 4.09x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 917 | $199.2K | $217.26 | 11.42x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 675 | $195.4K | $289.55 | 6.81x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.3K | $161.0K | $125.96 | 3.84x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.5K | $142.0K | $94.20 | 4.82x |
| 66761 | Creation of eye fluid drainage tracts in iris using laser, per session | 550 | $138.6K | $251.91 | 5.67x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 2.7K | $118.8K | $44.38 | 7.32x |
| 92020 | Examination of cornea and iris using lens device and slit lamp | 3.0K | $69.1K | $23.06 | 3.79x |
| 92275 | Recording of retinal electrical responses to external stimuli | 501 | $66.0K | $131.83 | 2.88x |
| 92134 | Diagnostic imaging of retina | 970 | $33.0K | $34.01 | 4.69x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 241 | $26.7K | $110.76 | 1.95x |
| 76514 | Ultrasound of corneal structure and measurement | 1.9K | $20.0K | $10.45 | 8.09x |
| 68761 | Closure of tear duct opening using plug | 157 | $18.1K | $115.43 | 3.48x |
| 66183 | Insertion of eye fluid drainage device | 12 | $10.1K | $844.13 | 5.33x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 126 | $10.0K | $79.56 | 6.10x |
This provider submits charges 4.58 times higher than what Medicare actually pays.
A markup ratio of 4.58x means for every $100 Medicare pays, this provider initially charges $458. 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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