This provider's $8.7M in total Medicare payments ranks in the 98th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 66% 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 | $514.74 | $285.07 | 1.81x | $229.67 | $692.5K | 6.3K | 3.3K |
| 2015 | $485.73 | $240.44 | 2.02x | $245.29 | $732.8K | 5.9K | 2.9K |
| 2016 | $565.33 | $238.19 | 2.37x | $327.14 | $786.7K | 6.2K | 3.2K |
| 2017 | $284.44 | $136.56 | 2.08x | $147.88 | $732.1K | 6.6K | 3.3K |
| 2018 | $285.77 | $140.63 | 2.03x | $145.14 | $777.1K | 7.8K | 4.0K |
| 2019 | $405.55 | $175.55 | 2.31x | $230.00 | $881.7K | 9.3K | 4.6K |
| 2020 | $463.09 | $181.16 | 2.56x | $281.93 | $842.3K | 9.1K | 4.2K |
| 2021 | $481.80 | $131.57 | 3.66x | $350.23 | $1.1M | 11.7K | 5.2K |
| 2022 | $417.83 | $124.50 | 3.36x | $293.33 | $984.0K | 11.3K | 5.2K |
| 2023 | $848.60 | $224.68 | 3.78x | $623.92 | $1.2M | 11.7K | 4.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 3.2K | $2.3M | $729.66 | 1.97x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 19.3K | $2.0M | $105.48 | 1.95x |
| J2778 | Injection, ranibizumab, 0.1 mg | 3.0K | $812.4K | $266.53 | 2.14x |
| 67028 | Injection of drug into eye | 7.6K | $756.8K | $98.95 | 5.21x |
| 92134 | Diagnostic imaging of retina | 17.0K | $617.6K | $36.34 | 5.58x |
| 92250 | Photography of the retina | 7.3K | $442.3K | $60.53 | 2.02x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.7K | $375.6K | $102.40 | 1.94x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 2.6K | $236.6K | $90.32 | 2.71x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.7K | $229.9K | $133.79 | 1.95x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 5.5K | $124.6K | $22.55 | 2.10x |
| 92202 | Extended examination of eye with drawing of optic nerve and surrounding area (macula) | 8.5K | $115.3K | $13.64 | 6.21x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 233 | $101.7K | $436.32 | 3.51x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 354 | $56.2K | $158.74 | 2.58x |
| J3490 | Unclassified drugs | 28 | $51.3K | $1.8K | 3.14x |
| 92201 | Extended examination of eye with drawing of retina | 2.3K | $50.4K | $21.51 | 3.77x |
| 92287 | Imaging and evaluation of deep cells of the eye | 391 | $48.5K | $123.93 | 2.05x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 433 | $33.9K | $78.29 | 1.86x |
| 67040 | Laser destruction of eye fluid (vitreous) between the lens and retina | 29 | $32.0K | $1.1K | 2.53x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 257 | $31.3K | $121.63 | 1.94x |
| 67041 | Removal of membrane from the retina | 28 | $29.4K | $1.1K | 2.66x |
This provider submits charges 2.67 times higher than what Medicare actually pays.
A markup ratio of 2.67x means for every $100 Medicare pays, this provider initially charges $267. 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 MD for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Michael Elman, M.D. | Baltimore, MD | $68.5M | ✓ Clear |
| David Warrow, M.D. | Hagerstown, MD | $65.5M | ✓ Clear |
| Raymond Sjaarda, M.D. | Baltimore, MD | $47.2M | ✓ Clear |
| Allen Hu, MD | Hagerstown, MD | $45.7M | ✓ Clear |
| James Rial, M.D. | Salisbury, MD | $45.2M | ✓ 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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