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 | $854.03 | $356.88 | 2.39x | $497.15 | $1.4M | 12.8K | 5.1K |
| 2015 | $753.04 | $268.76 | 2.80x | $484.28 | $1.3M | 12.4K | 4.8K |
| 2016 | $640.62 | $209.25 | 3.06x | $431.37 | $1.2M | 12.3K | 4.5K |
| 2017 | $685.02 | $208.89 | 3.28x | $476.13 | $1.3M | 12.9K | 5.1K |
| 2018 | $535.33 | $201.63 | 2.66x | $333.70 | $1.3M | 12.6K | 4.8K |
| 2019 | $516.13 | $192.72 | 2.68x | $323.41 | $1.2M | 12.5K | 4.7K |
| 2020 | $296.16 | $118.02 | 2.51x | $178.14 | $1.1M | 11.7K | 4.6K |
| 2021 | $484.95 | $186.17 | 2.60x | $298.78 | $1.2M | 11.8K | 4.6K |
| 2022 | $291.70 | $119.74 | 2.44x | $171.96 | $1.1M | 11.6K | 4.8K |
| 2023 | $307.44 | $125.05 | 2.46x | $182.39 | $983.4K | 10.7K | 4.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 5.2K | $3.9M | $745.79 | 1.86x |
| 67028 | Injection of drug into eye | 19.5K | $1.8M | $90.62 | 5.98x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 18.7K | $1.2M | $62.94 | 2.49x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 12.6K | $877.0K | $69.49 | 2.69x |
| 92250 | Photography of the retina | 19.1K | $787.3K | $41.26 | 4.64x |
| J7999 | Compounded drug, not otherwise classified | 10.4K | $705.6K | $67.67 | 1.63x |
| 92134 | Diagnostic imaging of retina | 19.2K | $690.8K | $35.92 | 2.67x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 6.8K | $690.7K | $101.82 | 2.70x |
| J2778 | Injection, ranibizumab, 0.1 mg | 2.2K | $657.1K | $303.22 | 2.01x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 4.0K | $349.2K | $87.83 | 3.54x |
| 67041 | Removal of membrane from the retina | 191 | $196.3K | $1.0K | 2.52x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 698 | $80.5K | $115.33 | 2.91x |
| J3590 | Unclassified biologics | 1.3K | $68.6K | $51.76 | 2.13x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 73 | $45.7K | $626.55 | 3.87x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 94 | $41.8K | $444.38 | 3.02x |
| 67042 | Removal of membrane from the retina, pars plana approach | 26 | $29.8K | $1.1K | 2.47x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 17 | $23.3K | $1.4K | 2.32x |
| 67040 | Laser destruction of eye fluid (vitreous) between the lens and retina | 16 | $19.0K | $1.2K | 2.59x |
| 92133 | Diagnostic imaging of optic nerve of eye | 429 | $13.6K | $31.63 | 3.00x |
| 92083 | Measurement of field of vision during daylight conditions | 242 | $13.1K | $54.22 | 2.85x |
This provider submits charges 2.94 times higher than what Medicare actually pays.
A markup ratio of 2.94x means for every $100 Medicare pays, this provider initially charges $294. 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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