This provider averages 54 services per working day
Based on 134.7K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $31.1M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 54 services per working day raises questions about billing patterns.
77% of their billing comes from a single procedure code (J0178 — Injection, aflibercept, 1 mg).
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 | $306.23 | $204.26 | 1.50x | $101.97 | $2.5M | 12.1K | 20 |
| 2015 | $305.19 | $222.41 | 1.37x | $82.78 | $2.7M | 12.0K | 21 |
| 2016 | $312.83 | $226.07 | 1.38x | $86.76 | $2.8M | 12.4K | 19 |
| 2017 | $347.31 | $239.59 | 1.45x | $107.72 | $2.9M | 12.3K | 21 |
| 2018 | $341.82 | $263.03 | 1.30x | $78.79 | $3.2M | 12.2K | 20 |
| 2019 | $406.55 | $309.37 | 1.31x | $97.18 | $3.6M | 11.7K | 17 |
| 2020 | $473.06 | $337.90 | 1.40x | $135.16 | $3.3M | 9.8K | 16 |
| 2021 | $443.31 | $332.40 | 1.33x | $110.91 | $3.5M | 10.5K | 17 |
| 2022 | $337.00 | $235.07 | 1.43x | $101.93 | $3.4M | 14.3K | 20 |
| 2023 | $162.06 | $118.48 | 1.37x | $43.58 | $3.2M | 27.4K | 17 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 31.8K | $23.6M | $743.24 | 1.31x |
| J2778 | Injection, ranibizumab, 0.1 mg | 7.1K | $2.0M | $289.01 | 1.36x |
| 67028 | Injection of drug into eye | 16.6K | $1.6M | $95.59 | 2.07x |
| 92134 | Imaging of retina | 24.8K | $828.5K | $33.34 | 1.53x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 23.0K | $673.9K | $29.25 | 1.41x |
| 92012 | Established patient problem focused exam of visual system | 9.1K | $598.7K | $65.60 | 1.50x |
| J3590 | Unclassified biologics | 769 | $218.8K | $284.58 | 2.12x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 200 | $200.4K | $1.0K | 1.41x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 8.6K | $167.0K | $19.38 | 1.61x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 1.7K | $147.8K | $87.55 | 1.46x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 134 | $146.4K | $1.1K | 1.37x |
| J7999 | Compounded drug, not otherwise classified | 1.6K | $102.6K | $62.49 | 2.18x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 176 | $77.7K | $441.40 | 1.42x |
| 92014 | Established patient complete exam of visual system | 739 | $76.5K | $103.46 | 1.44x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 477 | $75.2K | $157.62 | 1.45x |
| 92004 | New patient complete exam of visual system | 547 | $62.7K | $114.64 | 1.49x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 453 | $54.7K | $120.75 | 1.56x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 2.2K | $47.9K | $22.18 | 1.50x |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 622 | $47.4K | $76.25 | 1.59x |
| 92250 | Photography of the retina | 1.0K | $46.3K | $45.57 | 1.44x |
This provider submits charges 1.38 times higher than what Medicare actually pays.
A markup ratio of 1.38x means for every $100 Medicare pays, this provider initially charges $138. This is lower 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 |
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