This provider averages 70 services per working day
Based on 175.0K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $43.3M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 70 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 54% from 2014 to 2023.
75% of their billing comes from a single procedure code (J0178 — Injection, aflibercept, 1 mg).
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 | $393.15 | $212.54 | 1.85x | $180.61 | $3.1M | 14.6K | 24 |
| 2015 | $421.54 | $222.39 | 1.90x | $199.15 | $3.3M | 14.8K | 23 |
| 2016 | $447.25 | $237.94 | 1.88x | $209.31 | $4.2M | 17.6K | 21 |
| 2017 | $456.40 | $249.90 | 1.83x | $206.50 | $4.9M | 19.5K | 24 |
| 2018 | $485.99 | $265.56 | 1.83x | $220.43 | $5.3M | 20.0K | 22 |
| 2019 | $477.93 | $259.80 | 1.84x | $218.13 | $5.1M | 19.4K | 18 |
| 2020 | $510.39 | $282.35 | 1.81x | $228.04 | $4.2M | 14.8K | 19 |
| 2021 | $506.40 | $280.25 | 1.81x | $226.15 | $4.2M | 14.8K | 18 |
| 2022 | $512.68 | $275.97 | 1.86x | $236.71 | $4.3M | 15.7K | 19 |
| 2023 | $383.43 | $201.38 | 1.90x | $182.05 | $4.8M | 23.7K | 24 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 42.6K | $31.8M | $744.78 | 1.61x |
| 67028 | Injection of drug into eye | 23.3K | $2.3M | $97.23 | 3.45x |
| J2778 | Injection, ranibizumab, 0.1 mg | 5.8K | $1.7M | $294.21 | 1.63x |
| 92014 | Established patient complete exam of visual system | 15.7K | $1.6M | $99.83 | 1.74x |
| 92134 | Imaging of retina | 31.7K | $1.1M | $36.09 | 2.92x |
| 92012 | Established patient problem focused exam of visual system | 9.9K | $713.7K | $72.34 | 2.03x |
| J3590 | Unclassified biologics | 234 | $495.6K | $2.1K | 1.68x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 4.8K | $448.0K | $92.43 | 2.64x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 4.1K | $432.6K | $105.80 | 2.25x |
| J3490 | Unclassified drugs | 190 | $336.0K | $1.8K | 1.52x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 471 | $249.5K | $529.76 | 4.56x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 1.5K | $243.8K | $157.68 | 2.22x |
| 92250 | Photography of the retina | 4.1K | $224.5K | $54.94 | 1.85x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 6.9K | $201.4K | $29.18 | 1.39x |
| 92004 | New patient complete exam of visual system | 1.3K | $156.9K | $118.92 | 2.08x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 1.2K | $144.4K | $120.36 | 1.63x |
| 67042 | Removal of membrane from the retina, pars plana approach | 132 | $142.3K | $1.1K | 4.04x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 5.4K | $119.0K | $21.98 | 2.26x |
| J9035 | Injection, bevacizumab, 10 mg | 2.1K | $115.3K | $55.95 | 4.58x |
| 76512 | 2d ultrasound scan of eye tissue and structures | 1.4K | $94.3K | $65.91 | 3.71x |
This provider submits charges 1.85 times higher than what Medicare actually pays.
A markup ratio of 1.85x means for every $100 Medicare pays, this provider initially charges $185. 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 NJ for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Howard Fine, MD MHSC | New Brunswick, NJ | $44.5M | ✓ Clear |
| Jonathan Prenner, MD | New Brunswick, NJ | $43.1M | ✓ Clear |
| Sumit Shah, M.D. | New Brunswick, NJ | $37.0M | ✓ Clear |
| David Kim, M.D. | Union, NJ | $36.1M | ✓ Clear |
| Leonard Feiner, M.D | Union, NJ | $36.0M | ✓ 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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