This provider averages 67 services per working day
Based on 167.0K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $24.5M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 67 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 844% from 2014 to 2023.
74% of their billing comes from a single procedure code (J0178 — Injection, aflibercept, 1 mg).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 94% 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 | $254.40 | $102.97 | 2.47x | $151.43 | $410.2K | 4.0K | 17 |
| 2015 | $326.85 | $125.85 | 2.60x | $201.00 | $795.7K | 6.3K | 16 |
| 2016 | $370.56 | $146.78 | 2.52x | $223.78 | $1.5M | 9.9K | 18 |
| 2017 | $369.74 | $149.60 | 2.47x | $220.14 | $1.8M | 11.7K | 17 |
| 2018 | $375.81 | $155.92 | 2.41x | $219.89 | $2.3M | 14.7K | 18 |
| 2019 | $393.08 | $165.22 | 2.38x | $227.86 | $2.8M | 16.7K | 17 |
| 2020 | $493.25 | $212.64 | 2.32x | $280.61 | $3.1M | 14.6K | 14 |
| 2021 | $490.00 | $211.71 | 2.31x | $278.29 | $4.1M | 19.3K | 16 |
| 2022 | $408.41 | $171.47 | 2.38x | $236.94 | $4.0M | 23.4K | 16 |
| 2023 | $193.98 | $83.37 | 2.33x | $110.61 | $3.9M | 46.4K | 16 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 24.3K | $17.9M | $737.43 | 1.88x |
| 92012 | Established patient problem focused exam of visual system | 19.3K | $1.2M | $64.07 | 3.37x |
| 67028 | Injection of drug into eye | 14.4K | $1.2M | $84.11 | 6.98x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 33.9K | $993.8K | $29.28 | 1.58x |
| 92134 | Imaging of retina | 21.7K | $669.7K | $30.83 | 3.24x |
| 92014 | Established patient complete exam of visual system | 5.1K | $453.4K | $89.75 | 3.31x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 18.5K | $343.9K | $18.62 | 3.49x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 2.1K | $250.7K | $121.01 | 3.83x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 1.5K | $233.3K | $154.89 | 1.27x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 2.4K | $188.4K | $78.78 | 4.20x |
| 92202 | Extended exam of the back part of the eye with optic nerve drawing | 14.7K | $172.2K | $11.69 | 4.12x |
| 92250 | Photography of the retina | 2.8K | $133.9K | $47.06 | 4.19x |
| J3490 | Unclassified drugs | 156 | $116.4K | $745.99 | 1.52x |
| J2778 | Injection, ranibizumab, 0.1 mg | 320 | $99.2K | $309.98 | 1.45x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 99 | $88.7K | $896.06 | 4.19x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 215 | $73.2K | $340.40 | 4.19x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 2.6K | $54.0K | $20.93 | 3.50x |
| 99214 | Established patient outpatient visit, total time 30-39 minutes | 558 | $43.9K | $78.68 | 3.74x |
| 92240 | Examination of eye using an endoscope | 202 | $39.7K | $196.39 | 2.14x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 38 | $37.2K | $978.33 | 4.62x |
This provider submits charges 2.38 times higher than what Medicare actually pays.
A markup ratio of 2.38x means for every $100 Medicare pays, this provider initially charges $238. 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 FL for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Alexander Eaton, MD | Fort Myers, FL | $99.5M | ✓ Clear |
| Sunil Gupta, M.D. | Pensacola, FL | $86.1M | ✓ Clear |
| Hussein Wafapoor, M.D. | Fort Myers, FL | $70.9M | ✓ Clear |
| John Myers, M.D. | Pensacola, FL | $69.4M | ✓ Clear |
| Thomas Baudo, M.D. | Vero Beach, FL | $64.2M | ✓ 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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