This provider's $24.8M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 253% from 2014 to 2023.
70% of their billing comes from a single procedure code (J0178 — Injection, aflibercept, 1 mg).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 88% in 2015
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 | $508.38 | $192.53 | 2.64x | $315.85 | $843.5K | 4.4K | 21 |
| 2015 | $461.11 | $186.15 | 2.48x | $274.96 | $1.6M | 8.5K | 20 |
| 2016 | $462.54 | $177.50 | 2.61x | $285.04 | $1.8M | 10.1K | 21 |
| 2017 | $449.71 | $193.08 | 2.33x | $256.63 | $2.2M | 11.3K | 20 |
| 2018 | $435.54 | $184.30 | 2.36x | $251.24 | $2.8M | 15.2K | 21 |
| 2019 | $556.70 | $237.91 | 2.34x | $318.79 | $3.1M | 13.2K | 20 |
| 2020 | $570.62 | $255.90 | 2.23x | $314.72 | $3.0M | 11.8K | 18 |
| 2021 | $567.14 | $253.95 | 2.23x | $313.19 | $3.4M | 13.2K | 19 |
| 2022 | $490.96 | $216.74 | 2.27x | $274.22 | $3.1M | 14.2K | 19 |
| 2023 | $319.91 | $131.93 | 2.42x | $187.98 | $3.0M | 22.6K | 19 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 22.9K | $16.9M | $739.67 | 1.68x |
| 92014 | Established patient complete exam of visual system | 13.1K | $1.4M | $106.44 | 1.80x |
| 67028 | Injection of drug into eye | 11.7K | $1.2M | $104.61 | 8.49x |
| 92134 | Imaging of retina | 29.3K | $1.1M | $36.65 | 4.75x |
| J2778 | Injection, ranibizumab, 0.1 mg | 2.2K | $649.3K | $297.14 | 1.67x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 5.8K | $633.3K | $108.65 | 1.92x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 12.4K | $361.6K | $29.25 | 1.44x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 1.4K | $351.4K | $250.27 | 1.66x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 3.8K | $278.5K | $73.71 | 1.75x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 190 | $184.1K | $969.03 | 3.21x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 7.0K | $178.6K | $25.67 | 5.55x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 1.5K | $177.7K | $115.59 | 3.49x |
| J3590 | Unclassified biologics | 432 | $131.2K | $303.69 | 2.02x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 4.3K | $119.7K | $28.06 | 4.94x |
| 67210 | Destruction of growth of retina using a laser | 219 | $106.1K | $484.38 | 4.99x |
| 92273 | Measurement of retinal and optic nerve function | 848 | $103.2K | $121.76 | 3.29x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 232 | $101.4K | $436.95 | 4.56x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 93 | $100.3K | $1.1K | 3.24x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 219 | $92.8K | $423.64 | 5.77x |
| 76512 | 2d ultrasound scan of eye tissue and structures | 1.4K | $89.5K | $62.65 | 5.84x |
This provider submits charges 2.35 times higher than what Medicare actually pays.
A markup ratio of 2.35x means for every $100 Medicare pays, this provider initially charges $235. 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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