This provider's $18.7M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 95% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 68% 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 | $475.11 | $279.68 | 1.70x | $195.43 | $1.1M | 11.3K | 4.6K |
| 2015 | $485.12 | $192.65 | 2.52x | $292.47 | $1.8M | 14.0K | 5.1K |
| 2016 | $399.71 | $146.62 | 2.73x | $253.09 | $1.6M | 12.5K | 4.7K |
| 2017 | $323.24 | $132.43 | 2.44x | $190.81 | $1.7M | 11.3K | 4.5K |
| 2018 | $481.00 | $173.35 | 2.77x | $307.65 | $1.9M | 11.9K | 3.8K |
| 2019 | $406.59 | $145.62 | 2.79x | $260.97 | $2.2M | 12.4K | 4.1K |
| 2020 | $466.62 | $166.25 | 2.81x | $300.37 | $1.9M | 10.8K | 3.4K |
| 2021 | $509.11 | $169.53 | 3.00x | $339.58 | $2.2M | 11.7K | 3.5K |
| 2022 | $484.65 | $159.24 | 3.04x | $325.41 | $2.2M | 12.4K | 4.1K |
| 2023 | $467.19 | $164.42 | 2.84x | $302.77 | $2.1M | 12.3K | 4.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 20.2K | $9.4M | $467.41 | 2.53x |
| J0178 | Injection, aflibercept, 1 mg | 3.4K | $2.5M | $752.40 | 1.59x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 2.5K | $1.2M | $477.72 | 3.59x |
| 92250 | Photography of the retina | 25.1K | $1.2M | $47.53 | 2.80x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 12.5K | $896.8K | $71.79 | 2.57x |
| 92134 | Diagnostic imaging of retina | 25.0K | $885.8K | $35.49 | 2.41x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 7.2K | $594.1K | $82.51 | 2.07x |
| 67028 | Injection of drug into eye | 6.0K | $534.8K | $89.13 | 2.22x |
| 92275 | Recording of retinal electrical responses to external stimuli | 1.9K | $236.5K | $125.95 | 2.19x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 1.7K | $171.7K | $102.69 | 2.59x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 1.2K | $145.6K | $120.85 | 2.70x |
| 92083 | Measurement of field of vision during daylight conditions | 2.4K | $124.3K | $51.13 | 2.90x |
| J9035 | Injection, bevacizumab, 10 mg | 2.0K | $107.6K | $54.80 | 2.27x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 4.5K | $91.8K | $20.24 | 1.94x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 989 | $85.8K | $86.71 | 2.52x |
| 92240 | Examination of eye using an endoscope | 404 | $84.2K | $208.33 | 1.98x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 437 | $54.9K | $125.60 | 2.13x |
| 67042 | Removal of membrane from the retina, pars plana approach | 46 | $50.0K | $1.1K | 2.23x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 453 | $48.0K | $106.06 | 1.92x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 149 | $37.3K | $250.12 | 2.45x |
This provider submits charges 2.45 times higher than what Medicare actually pays.
A markup ratio of 2.45x means for every $100 Medicare pays, this provider initially charges $245. 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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