This provider's $3.8M in total Medicare payments ranks in the 95th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 16171% from 2015 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 652% in 2018
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 |
|---|---|---|---|---|---|---|---|
| 2015 | $188.83 | $49.46 | 3.82x | $139.37 | $8.1K | 183 | 161 |
| 2016 | $386.26 | $63.99 | 6.04x | $322.27 | $49.4K | 1.1K | 730 |
| 2017 | $221.38 | $67.46 | 3.28x | $153.92 | $44.6K | 821 | 677 |
| 2018 | $393.18 | $142.65 | 2.76x | $250.53 | $335.9K | 3.8K | 2.4K |
| 2019 | $422.76 | $156.76 | 2.70x | $266.00 | $375.9K | 4.0K | 2.0K |
| 2020 | $471.30 | $151.47 | 3.11x | $319.83 | $398.7K | 4.0K | 2.1K |
| 2021 | $250.90 | $114.61 | 2.19x | $136.29 | $233.5K | 2.4K | 1.7K |
| 2022 | $995.42 | $212.20 | 4.69x | $783.22 | $988.5K | 8.6K | 4.1K |
| 2023 | $1.4K | $332.60 | 4.07x | $1.0K | $1.3M | 11.0K | 4.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 1.8K | $1.3M | $699.56 | 2.99x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 8.1K | $817.1K | $100.29 | 2.57x |
| 67028 | Injection of drug into eye | 4.3K | $404.9K | $95.06 | 6.13x |
| 92134 | Diagnostic imaging of retina | 9.1K | $296.0K | $32.68 | 8.01x |
| J2778 | Injection, ranibizumab, 0.1 mg | 542 | $111.6K | $205.89 | 4.36x |
| 92242 | Imaging of blood vessels in back of eye using fluorescein and indocyanine-green dye | 500 | $103.1K | $206.14 | 2.52x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 721 | $79.6K | $110.46 | 2.08x |
| J7999 | Compounded drug, not otherwise classified | 1.1K | $78.5K | $68.72 | 3.35x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 576 | $74.5K | $129.40 | 3.12x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 183 | $49.1K | $268.50 | 7.97x |
| 92250 | Photography of the retina | 1.3K | $48.0K | $37.03 | 3.72x |
| 92202 | Extended examination of eye with drawing of optic nerve and surrounding area (macula) | 3.6K | $46.9K | $13.04 | 7.86x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 463 | $43.0K | $92.93 | 3.41x |
| J3490 | Unclassified drugs | 15 | $33.2K | $2.2K | 3.14x |
| 92083 | Measurement of field of vision during daylight conditions | 595 | $31.5K | $52.97 | 2.53x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 297 | $26.5K | $89.07 | 2.14x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 38 | $26.2K | $690.62 | 4.14x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 25 | $25.8K | $1.0K | 4.05x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 54 | $23.7K | $438.53 | 2.96x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 257 | $19.1K | $74.29 | 1.94x |
This provider submits charges 3.83 times higher than what Medicare actually pays.
A markup ratio of 3.83x means for every $100 Medicare pays, this provider initially charges $383. This is higher than the national average.
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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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