This provider's $14.0M in total Medicare payments ranks in the 99th 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 | $586.98 | $209.26 | 2.81x | $377.72 | $1.5M | 9.5K | 4.3K |
| 2015 | $455.68 | $182.08 | 2.50x | $273.60 | $1.5M | 10.3K | 4.5K |
| 2016 | $436.63 | $148.84 | 2.93x | $287.79 | $1.4M | 8.9K | 3.9K |
| 2017 | $530.01 | $169.59 | 3.13x | $360.42 | $1.3M | 9.0K | 3.5K |
| 2018 | $510.33 | $179.35 | 2.85x | $330.98 | $1.3M | 9.7K | 3.6K |
| 2019 | $411.04 | $130.72 | 3.14x | $280.32 | $1.7M | 12.9K | 4.6K |
| 2020 | $416.70 | $142.74 | 2.92x | $273.96 | $1.4M | 9.3K | 3.5K |
| 2021 | $406.45 | $140.52 | 2.89x | $265.93 | $1.3M | 9.2K | 3.5K |
| 2022 | $566.31 | $232.05 | 2.44x | $334.26 | $1.4M | 9.5K | 3.5K |
| 2023 | $558.94 | $229.71 | 2.43x | $329.23 | $1.2M | 10.2K | 3.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 9.2K | $6.9M | $749.59 | 1.53x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 15.2K | $1.6M | $104.61 | 2.12x |
| 67028 | Injection of drug into eye | 11.4K | $1.1M | $94.97 | 8.51x |
| 92134 | Diagnostic imaging of retina | 19.7K | $735.4K | $37.24 | 10.80x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 5.7K | $629.7K | $110.26 | 1.82x |
| 92250 | Photography of the retina | 14.0K | $626.5K | $44.81 | 3.89x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 3.8K | $520.9K | $138.75 | 4.32x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 8.4K | $293.1K | $34.99 | 5.78x |
| 92240 | Examination of eye using an endoscope | 568 | $242.1K | $426.26 | 2.62x |
| 92242 | Imaging of blood vessels in back of eye using fluorescein and indocyanine-green dye | 1.1K | $237.8K | $221.66 | 6.07x |
| J2778 | Injection, ranibizumab, 0.1 mg | 682 | $202.8K | $297.36 | 1.58x |
| J3490 | Unclassified drugs | 93 | $165.1K | $1.8K | 1.70x |
| 92273 | Full field recording of retinal electrical responses to external stimuli with interpretation and report | 1.0K | $121.4K | $118.10 | 2.71x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 967 | $117.8K | $121.77 | 2.64x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 1.0K | $75.4K | $72.95 | 2.02x |
| 67027 | Implantation of eye drug delivery system | 78 | $58.7K | $752.37 | 1.32x |
| J3590 | Unclassified biologics | 29 | $51.8K | $1.8K | 1.68x |
| 99204 | New patient outpatient visit, total time 45-59 minutes | 333 | $46.7K | $140.26 | 2.50x |
| 92083 | Measurement of field of vision during daylight conditions | 880 | $45.7K | $51.88 | 4.34x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 250 | $39.5K | $158.05 | 1.63x |
This provider submits charges 3.11 times higher than what Medicare actually pays.
A markup ratio of 3.11x means for every $100 Medicare pays, this provider initially charges $311. 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 NY for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Jonathan Jonisch, MD | Great Neck, NY | $52.3M | ✓ Clear |
| Jeffrey Josef, M.D. | Suffern, NY | $52.2M | ✓ Clear |
| Brett Rosenblatt | Great Neck, NY | $50.0M | ✓ Clear |
| Kenneth Graham | Great Neck, NY | $47.1M | ✓ Clear |
| Glenn Stoller, M.D. | Rockville Centre, NY | $46.4M | ✓ 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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