This provider's $21.1M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 119% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 66% in 2021
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 | $514.57 | $202.38 | 2.54x | $312.19 | $1.3M | 6.6K | 14 |
| 2015 | $474.28 | $182.54 | 2.60x | $291.74 | $1.9M | 10.2K | 16 |
| 2016 | $484.17 | $181.27 | 2.67x | $302.90 | $2.1M | 11.5K | 18 |
| 2017 | $521.14 | $195.72 | 2.66x | $325.42 | $1.7M | 8.8K | 14 |
| 2018 | $495.05 | $187.20 | 2.64x | $307.85 | $1.6M | 8.8K | 15 |
| 2019 | $535.45 | $203.18 | 2.64x | $332.27 | $2.3M | 11.2K | 14 |
| 2020 | $530.87 | $194.06 | 2.74x | $336.81 | $1.6M | 8.3K | 16 |
| 2021 | $591.61 | $214.21 | 2.76x | $377.40 | $2.7M | 12.5K | 17 |
| 2022 | $585.04 | $201.28 | 2.91x | $383.76 | $3.0M | 14.8K | 15 |
| 2023 | $460.67 | $151.46 | 3.04x | $309.21 | $2.9M | 19.4K | 16 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2778 | Injection, ranibizumab, 0.1 mg | 35.4K | $9.1M | $257.54 | 2.39x |
| J0178 | Injection, aflibercept, 1 mg | 11.0K | $8.1M | $736.99 | 2.05x |
| 67028 | Injection of drug into eye | 15.4K | $1.3M | $82.36 | 9.59x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 9.9K | $749.6K | $75.35 | 3.40x |
| 92134 | Imaging of retina | 17.1K | $499.2K | $29.24 | 3.45x |
| 92014 | Established patient complete exam of visual system | 3.5K | $300.6K | $84.66 | 2.02x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 5.1K | $280.6K | $54.90 | 2.39x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 3.1K | $230.4K | $75.29 | 2.35x |
| J9035 | Injection, bevacizumab, 10 mg | 2.3K | $128.7K | $55.66 | 3.52x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 3.7K | $107.5K | $28.88 | 1.45x |
| 92012 | Established patient problem focused exam of visual system | 1.5K | $87.8K | $58.72 | 2.21x |
| 92250 | Photography of the retina | 1.3K | $56.2K | $43.13 | 2.89x |
| J7999 | Compounded drug, not otherwise classified | 567 | $38.7K | $68.26 | 2.57x |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 953 | $35.2K | $36.96 | 2.42x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 247 | $28.1K | $113.88 | 2.27x |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 301 | $21.6K | $71.89 | 2.77x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 28 | $19.1K | $682.76 | 3.22x |
| J3590 | Unclassified biologics | 256 | $14.0K | $54.64 | 3.34x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 14 | $11.1K | $791.00 | 2.78x |
| 67041 | Removal of membrane from the retina | 12 | $10.5K | $875.32 | 2.74x |
This provider submits charges 2.75 times higher than what Medicare actually pays.
A markup ratio of 2.75x means for every $100 Medicare pays, this provider initially charges $275. 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 PA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Richard Kaiser, MD | Plymouth Meeting, PA | $75.2M | ✓ Clear |
| Allen Ho, MD | Plymouth Meeting, PA | $67.7M | ✓ Clear |
| Carl Regillo, MD | Plymouth Meeting, PA | $63.5M | ✓ Clear |
| Marc Spirn, MD | Plymouth Meeting, PA | $63.4M | ✓ Clear |
| Mitchell Fineman, MD | Plymouth Meeting, PA | $61.7M | ✓ Clear |
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