This provider's $12.1M in total Medicare payments ranks in the 98th 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 | $278.21 | $186.44 | 1.49x | $91.77 | $1.6M | 10.4K | 7.9K |
| 2015 | $376.67 | $185.65 | 2.03x | $191.02 | $1.5M | 9.9K | 7.6K |
| 2016 | $281.32 | $171.14 | 1.64x | $110.18 | $1.5M | 10.2K | 7.9K |
| 2017 | $206.15 | $135.98 | 1.52x | $70.17 | $1.2M | 7.9K | 6.0K |
| 2018 | $303.23 | $145.73 | 2.08x | $157.50 | $1.0M | 5.3K | 3.9K |
| 2019 | $290.88 | $143.01 | 2.03x | $147.87 | $1.4M | 7.2K | 5.3K |
| 2020 | $325.65 | $163.93 | 1.99x | $161.72 | $1.2M | 6.2K | 4.3K |
| 2021 | $335.62 | $174.59 | 1.92x | $161.03 | $1.2M | 6.5K | 4.4K |
| 2022 | $460.91 | $177.41 | 2.60x | $283.50 | $832.7K | 5.8K | 4.0K |
| 2023 | $727.65 | $179.98 | 4.04x | $547.67 | $702.5K | 5.0K | 3.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 12.7K | $5.6M | $443.27 | 2.13x |
| 66982 | Removal of cataract with insertion of lens | 2.7K | $1.5M | $559.11 | 1.85x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 13.7K | $1.1M | $78.89 | 1.56x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 3.5K | $844.6K | $243.76 | 2.22x |
| 92136 | Measurement of corneal curvature and depth of eye | 15.3K | $604.6K | $39.39 | 2.00x |
| 0191T | Internal insertion of eye fluid drainage device | 607 | $411.8K | $678.44 | 1.74x |
| 0356T | Insertion of drug delivery implant into tear ducts | 1.8K | $361.8K | $202.44 | 1.46x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 5.3K | $311.3K | $58.56 | 1.46x |
| 67904 | Repair of tendon of upper eyelid | 275 | $224.4K | $815.95 | 1.95x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 2.0K | $197.5K | $96.64 | 1.54x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.0K | $165.7K | $81.27 | 2.58x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 1.4K | $98.0K | $71.15 | 1.77x |
| 66761 | Creation of eye fluid drainage tracts in iris using laser, per session | 432 | $93.4K | $216.11 | 2.05x |
| 92250 | Photography of the retina | 1.7K | $86.2K | $49.50 | 1.58x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 180 | $69.7K | $387.38 | 1.36x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 642 | $66.7K | $103.96 | 2.75x |
| 92134 | Diagnostic imaging of retina | 1.8K | $52.2K | $29.40 | 2.23x |
| 92083 | Measurement of field of vision during daylight conditions | 1.2K | $49.7K | $41.35 | 2.03x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 163 | $38.0K | $233.43 | 1.39x |
| 92133 | Diagnostic imaging of optic nerve of eye | 1.1K | $31.3K | $27.63 | 2.35x |
This provider submits charges 1.98 times higher than what Medicare actually pays.
A markup ratio of 1.98x means for every $100 Medicare pays, this provider initially charges $198. 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 NC for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Shil Patel, M.D. | New Bern, NC | $63.1M | ✓ Clear |
| James Pate, M.D. | Raleigh, NC | $44.5M | ✓ Clear |
| Justin Brown, M.D. | Charlotte, NC | $43.5M | ✓ Clear |
| Nitin Gupta, M.D., M.P.H. | Raleigh, NC | $42.0M | ✓ Clear |
| Igor Westra, MD | Wilmington, NC | $40.5M | ✓ 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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