This provider's $23.4M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 350% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 66% in 2016
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 | $244.77 | $132.62 | 1.85x | $112.15 | $665.0K | 5.0K | 12 |
| 2015 | $301.99 | $152.90 | 1.98x | $149.09 | $1.0M | 6.6K | 16 |
| 2016 | $379.70 | $196.39 | 1.93x | $183.31 | $1.7M | 8.5K | 15 |
| 2017 | $571.31 | $236.03 | 2.42x | $335.28 | $2.2M | 9.4K | 15 |
| 2018 | $630.70 | $251.35 | 2.51x | $379.35 | $2.7M | 10.5K | 14 |
| 2019 | $604.31 | $234.85 | 2.57x | $369.46 | $2.4M | 10.4K | 14 |
| 2020 | $603.82 | $228.39 | 2.64x | $375.43 | $2.9M | 12.7K | 12 |
| 2021 | $668.87 | $250.54 | 2.67x | $418.33 | $3.5M | 13.8K | 12 |
| 2022 | $746.05 | $263.82 | 2.83x | $482.23 | $3.4M | 12.7K | 11 |
| 2023 | $632.63 | $215.27 | 2.94x | $417.36 | $3.0M | 13.9K | 12 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 18.0K | $13.2M | $734.23 | 2.24x |
| J2778 | Injection, ranibizumab, 0.1 mg | 21.0K | $5.4M | $257.89 | 2.52x |
| 67028 | Injection of drug into eye | 14.5K | $1.5M | $100.56 | 6.74x |
| 92012 | Established patient problem focused exam of visual system | 12.6K | $1.0M | $83.13 | 1.83x |
| 92134 | Imaging of retina | 18.1K | $732.0K | $40.36 | 2.48x |
| 92014 | Established patient complete exam of visual system | 4.7K | $498.8K | $106.19 | 1.90x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.7K | $232.1K | $139.65 | 1.91x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 2.2K | $218.7K | $99.55 | 1.93x |
| 92250 | Photography of the retina | 3.5K | $182.8K | $52.29 | 2.44x |
| J7999 | Compounded drug, not otherwise classified | 1.3K | $82.1K | $62.51 | 1.34x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 3.1K | $78.2K | $25.54 | 2.76x |
| J3590 | Unclassified biologics | 729 | $37.1K | $50.90 | 1.44x |
| 76512 | 2d ultrasound scan of eye tissue and structures | 472 | $32.1K | $68.06 | 3.23x |
| 99205 | New patient outpatient visit, total time 60-74 minutes | 127 | $22.6K | $177.73 | 1.72x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 255 | $21.3K | $83.69 | 2.75x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 698 | $17.7K | $25.38 | 3.93x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 13 | $14.7K | $1.1K | 2.27x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 18 | $10.8K | $598.48 | 2.51x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 387 | $8.8K | $22.84 | 4.38x |
| Q9977 | Compounded Drug, Not Otherwise Classified | 152 | $8.3K | $54.31 | 1.44x |
This provider submits charges 2.57 times higher than what Medicare actually pays.
A markup ratio of 2.57x means for every $100 Medicare pays, this provider initially charges $257. 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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