This provider averages 66 services per working day
Based on 165.7K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $24.9M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 66 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 127% 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 | $360.37 | $159.05 | 2.27x | $201.32 | $1.6M | 10.1K | 21 |
| 2015 | $391.27 | $177.72 | 2.20x | $213.55 | $1.9M | 10.5K | 21 |
| 2016 | $433.15 | $181.43 | 2.39x | $251.72 | $2.1M | 11.8K | 23 |
| 2017 | $477.58 | $194.20 | 2.46x | $283.38 | $2.3M | 12.1K | 22 |
| 2018 | $441.01 | $177.95 | 2.48x | $263.06 | $2.3M | 13.1K | 26 |
| 2019 | $449.17 | $179.26 | 2.51x | $269.91 | $2.6M | 14.2K | 22 |
| 2020 | $480.31 | $181.67 | 2.64x | $298.64 | $2.1M | 11.5K | 21 |
| 2021 | $535.27 | $201.18 | 2.66x | $334.09 | $3.0M | 15.0K | 23 |
| 2022 | $420.71 | $154.97 | 2.71x | $265.74 | $3.3M | 21.4K | 24 |
| 2023 | $213.01 | $79.46 | 2.68x | $133.55 | $3.7M | 46.0K | 23 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 17.4K | $12.9M | $737.15 | 2.50x |
| J2778 | Injection, ranibizumab, 0.1 mg | 10.9K | $3.2M | $294.74 | 2.02x |
| 67028 | Injection of drug into eye | 16.0K | $1.3M | $82.09 | 2.82x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 37.0K | $1.1M | $29.22 | 2.57x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 13.2K | $1.0M | $76.25 | 2.71x |
| 92134 | Imaging of retina | 29.6K | $866.5K | $29.26 | 2.86x |
| J3590 | Unclassified biologics | 5.1K | $603.9K | $118.78 | 3.10x |
| 92014 | Established patient complete exam of visual system | 6.7K | $551.2K | $81.88 | 2.82x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 2.3K | $523.5K | $223.16 | 2.51x |
| 92012 | Established patient problem focused exam of visual system | 5.3K | $331.1K | $62.05 | 2.71x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 358 | $326.4K | $911.68 | 2.55x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 2.6K | $303.9K | $115.83 | 2.77x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 1.7K | $270.5K | $158.36 | 2.53x |
| J3490 | Unclassified drugs | 135 | $237.0K | $1.8K | 2.61x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 292 | $190.3K | $651.76 | 2.56x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 1.5K | $176.9K | $120.36 | 2.56x |
| 67210 | Destruction of growth of retina using a laser | 391 | $151.1K | $386.40 | 2.63x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 1.9K | $143.0K | $75.11 | 2.95x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 127 | $127.5K | $1.0K | 3.00x |
| 92250 | Photography of the retina | 2.3K | $89.1K | $39.44 | 3.52x |
This provider submits charges 2.53 times higher than what Medicare actually pays.
A markup ratio of 2.53x means for every $100 Medicare pays, this provider initially charges $253. This is higher than the national average.
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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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