This provider averages 57 services per working day
Based on 142.4K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $23.2M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 57 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 153% from 2014 to 2023.
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 | $291.01 | $148.94 | 1.95x | $142.07 | $1.5M | 9.9K | 19 |
| 2015 | $371.59 | $199.35 | 1.86x | $172.24 | $1.7M | 8.7K | 18 |
| 2016 | $403.31 | $218.66 | 1.84x | $184.65 | $2.0M | 9.0K | 16 |
| 2017 | $424.51 | $234.88 | 1.81x | $189.63 | $1.7M | 7.1K | 18 |
| 2018 | $419.02 | $227.18 | 1.84x | $191.84 | $1.9M | 8.3K | 19 |
| 2019 | $487.21 | $248.83 | 1.96x | $238.38 | $2.3M | 9.3K | 17 |
| 2020 | $595.70 | $244.04 | 2.44x | $351.66 | $2.5M | 10.4K | 17 |
| 2021 | $641.06 | $272.07 | 2.36x | $368.99 | $2.6M | 9.6K | 18 |
| 2022 | $484.74 | $194.93 | 2.49x | $289.81 | $3.3M | 17.0K | 21 |
| 2023 | $175.95 | $69.83 | 2.52x | $106.12 | $3.7M | 53.2K | 22 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 17.4K | $12.7M | $731.95 | 1.89x |
| J2778 | Injection, ranibizumab, 0.1 mg | 7.5K | $2.1M | $275.36 | 2.02x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 49.9K | $1.5M | $29.05 | 2.44x |
| 67028 | Injection of drug into eye | 13.9K | $1.2M | $89.56 | 4.01x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 4.7K | $1.1M | $245.20 | 3.20x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 5.6K | $870.6K | $155.08 | 1.71x |
| 92014 | Established patient complete exam of visual system | 8.3K | $760.1K | $91.11 | 2.03x |
| 92134 | Imaging of retina | 17.0K | $543.3K | $31.91 | 2.97x |
| J3590 | Unclassified biologics | 192 | $338.1K | $1.8K | 2.34x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 3.5K | $272.5K | $78.70 | 2.54x |
| 92240 | Examination of eye using an endoscope | 1.4K | $258.5K | $184.10 | 1.59x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 214 | $199.1K | $930.44 | 2.95x |
| 92250 | Photography of the retina | 4.1K | $152.2K | $37.50 | 3.04x |
| 92242 | Exam of retinal blood vessels and blood vessels between the white part of eye and retina using a special camera after injection of a dye | 768 | $145.5K | $189.46 | 1.65x |
| J9035 | Injection, bevacizumab, 10 mg | 2.4K | $127.3K | $53.25 | 1.60x |
| 67113 | Complex repair of detached retina and drainage of eye fluid between lens and retina | 99 | $109.1K | $1.1K | 2.66x |
| J3490 | Unclassified drugs | 61 | $105.8K | $1.7K | 1.61x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 846 | $101.6K | $120.11 | 2.23x |
| 92012 | Established patient problem focused exam of visual system | 1.2K | $79.4K | $67.04 | 1.91x |
| J7999 | Compounded drug, not otherwise classified | 1.1K | $72.3K | $66.20 | 3.18x |
This provider submits charges 2.18 times higher than what Medicare actually pays.
A markup ratio of 2.18x means for every $100 Medicare pays, this provider initially charges $218. 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 WA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Charles Sung, MD | Kennewick, WA | $38.3M | ✓ Clear |
| David Spinak, MD | Silverdale, WA | $34.8M | ✓ 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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