This provider's $13.0M 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 | $1.4K | $391.52 | 3.48x | $972.16 | $1.0M | 10.0K | 4.1K |
| 2015 | $945.80 | $286.60 | 3.30x | $659.20 | $1.2M | 9.9K | 3.6K |
| 2016 | $1.0K | $270.82 | 3.86x | $773.98 | $1.3M | 8.7K | 3.2K |
| 2017 | $1.2K | $307.87 | 3.92x | $898.56 | $1.3M | 9.1K | 3.4K |
| 2018 | $853.64 | $236.89 | 3.60x | $616.75 | $1.2M | 10.1K | 3.6K |
| 2019 | $1.1K | $275.26 | 4.07x | $846.11 | $1.4M | 10.6K | 4.1K |
| 2020 | $539.55 | $162.08 | 3.33x | $377.47 | $1.2M | 9.0K | 3.6K |
| 2021 | $498.75 | $191.32 | 2.61x | $307.43 | $1.3M | 8.3K | 2.5K |
| 2022 | $643.33 | $174.66 | 3.68x | $468.67 | $1.3M | 8.2K | 2.4K |
| 2023 | $440.18 | $129.08 | 3.41x | $311.10 | $1.6M | 12.2K | 3.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 10.2K | $7.5M | $738.45 | 1.69x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 27.4K | $2.1M | $75.84 | 2.31x |
| 67028 | Injection of drug into eye | 19.0K | $1.4M | $73.98 | 6.76x |
| 92134 | Diagnostic imaging of retina | 26.4K | $779.8K | $29.49 | 3.05x |
| J9035 | Injection, bevacizumab, 10 mg | 8.1K | $448.2K | $55.33 | 1.50x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.1K | $226.6K | $109.73 | 2.28x |
| 67042 | Removal of membrane from the retina, pars plana approach | 109 | $95.3K | $873.96 | 4.00x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 92 | $88.9K | $965.91 | 5.18x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 202 | $81.4K | $402.90 | 4.23x |
| 67145 | Preventive retinal detachment treatment by heat or laser, 1 or more sessions | 203 | $67.2K | $331.17 | 4.53x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.2K | $52.5K | $44.97 | 2.78x |
| 92250 | Photography of the retina | 564 | $26.8K | $47.57 | 2.63x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 12 | $15.5K | $1.3K | 4.63x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 85 | $12.6K | $147.82 | 2.42x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 13 | $9.4K | $726.46 | 4.82x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 26 | $9.2K | $354.55 | 4.23x |
| Q5124 | Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg | 56 | $9.1K | $161.93 | 1.46x |
| 67040 | Laser destruction of eye fluid (vitreous) between the lens and retina | 11 | $8.4K | $759.44 | 3.16x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 93 | $6.3K | $67.95 | 2.75x |
| 67105 | Repair of detached retina, 1 or more sessions | 12 | $6.1K | $510.58 | 2.94x |
This provider submits charges 2.52 times higher than what Medicare actually pays.
A markup ratio of 2.52x means for every $100 Medicare pays, this provider initially charges $252. 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.
Share this provider's Medicare payment information
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.
Believe this data is inaccurate? Dispute this data