This provider averages 60 services per working day
Based on 149.3K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $23.7M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 60 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 4149% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 664% in 2015
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 | $361.79 | $146.86 | 2.46x | $214.93 | $121.2K | 825 | 14 |
| 2015 | $352.99 | $152.30 | 2.32x | $200.69 | $925.2K | 6.1K | 21 |
| 2016 | $389.88 | $167.76 | 2.32x | $222.12 | $1.2M | 7.0K | 17 |
| 2017 | $465.92 | $211.87 | 2.20x | $254.05 | $1.4M | 6.7K | 18 |
| 2018 | $436.22 | $224.16 | 1.95x | $212.06 | $1.7M | 7.7K | 19 |
| 2019 | $487.90 | $252.44 | 1.93x | $235.46 | $2.6M | 10.1K | 18 |
| 2020 | $530.69 | $273.11 | 1.94x | $257.58 | $2.9M | 10.7K | 17 |
| 2021 | $545.58 | $278.12 | 1.96x | $267.46 | $3.8M | 13.8K | 19 |
| 2022 | $522.97 | $254.71 | 2.05x | $268.26 | $3.9M | 15.3K | 19 |
| 2023 | $150.38 | $72.47 | 2.08x | $77.91 | $5.1M | 71.0K | 20 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 15.1K | $11.0M | $730.94 | 1.71x |
| J2778 | Injection, ranibizumab, 0.1 mg | 24.7K | $6.3M | $254.54 | 1.96x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 59.8K | $1.7M | $29.00 | 1.97x |
| 67028 | Injection of drug into eye | 14.8K | $1.3M | $87.26 | 4.20x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 5.1K | $428.9K | $83.51 | 2.03x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 2.4K | $368.9K | $155.01 | 1.75x |
| J3590 | Unclassified biologics | 159 | $345.2K | $2.2K | 1.86x |
| 92134 | Imaging of retina | 12.0K | $342.0K | $28.46 | 2.45x |
| 92014 | Established patient complete exam of visual system | 3.9K | $315.9K | $81.35 | 2.36x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 350 | $273.4K | $781.17 | 3.30x |
| 67113 | Complex repair of detached retina and drainage of eye fluid between lens and retina | 197 | $189.3K | $960.72 | 2.88x |
| J9035 | Injection, bevacizumab, 10 mg | 2.4K | $134.8K | $56.50 | 2.73x |
| 67041 | Removal of membrane of retina | 143 | $126.4K | $884.02 | 2.86x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 357 | $116.0K | $325.06 | 4.98x |
| 67040 | Destruction of eye fluid (vitreous) between lens and retina and all of retina using a laser | 154 | $109.7K | $712.60 | 3.12x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 1.3K | $74.7K | $57.55 | 2.24x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1.4K | $70.5K | $52.19 | 2.18x |
| J7999 | Compounded drug, not otherwise classified | 1.1K | $68.5K | $64.60 | 4.59x |
| 92004 | New patient complete exam of visual system | 728 | $67.8K | $93.11 | 2.45x |
| J3490 | Unclassified drugs | 34 | $61.9K | $1.8K | 2.07x |
This provider submits charges 2.04 times higher than what Medicare actually pays.
A markup ratio of 2.04x means for every $100 Medicare pays, this provider initially charges $204. 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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