This provider averages 52 services per working day
Based on 128.9K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $15.6M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 52 services per working day raises questions about billing patterns.
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 | $411.40 | $221.31 | 1.86x | $190.09 | $1.2M | 10.2K | 3.0K |
| 2015 | $412.02 | $202.48 | 2.03x | $209.54 | $1.2M | 10.8K | 2.9K |
| 2016 | $421.18 | $209.71 | 2.01x | $211.47 | $1.4M | 11.7K | 2.8K |
| 2017 | $276.47 | $134.51 | 2.06x | $141.96 | $1.4M | 12.9K | 3.0K |
| 2018 | $398.70 | $174.15 | 2.29x | $224.55 | $1.7M | 13.9K | 3.2K |
| 2019 | $449.21 | $128.60 | 3.49x | $320.61 | $1.7M | 12.3K | 2.8K |
| 2020 | $467.04 | $120.84 | 3.86x | $346.20 | $1.7M | 13.0K | 4.9K |
| 2021 | $502.81 | $129.51 | 3.88x | $373.30 | $2.0M | 15.4K | 5.8K |
| 2022 | $481.63 | $121.90 | 3.95x | $359.73 | $1.7M | 14.3K | 6.3K |
| 2023 | $506.48 | $125.50 | 4.04x | $380.98 | $1.5M | 14.4K | 5.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 6.8K | $5.1M | $743.80 | 2.60x |
| 92242 | Imaging of blood vessels in back of eye using fluorescein and indocyanine-green dye | 7.5K | $1.7M | $221.52 | 3.13x |
| 67028 | Injection of drug into eye | 16.5K | $1.5M | $89.50 | 5.15x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 11.8K | $1.2M | $104.46 | 3.76x |
| J2778 | Injection, ranibizumab, 0.1 mg | 4.5K | $1.2M | $266.99 | 3.16x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 5.6K | $682.5K | $122.75 | 3.16x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.1K | $610.4K | $100.58 | 3.50x |
| 92250 | Photography of the retina | 13.0K | $606.4K | $46.70 | 3.03x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 7.9K | $576.9K | $73.07 | 2.06x |
| 92134 | Diagnostic imaging of retina | 14.6K | $516.6K | $35.37 | 4.97x |
| 92240 | Examination of eye using an endoscope | 1.2K | $502.9K | $414.25 | 1.38x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 13.9K | $366.1K | $26.35 | 3.07x |
| 92273 | Full field recording of retinal electrical responses to external stimuli with interpretation and report | 3.1K | $351.2K | $113.63 | 4.05x |
| J9035 | Injection, bevacizumab, 10 mg | 4.0K | $213.6K | $53.59 | 1.29x |
| 92083 | Measurement of field of vision during daylight conditions | 2.9K | $155.3K | $53.17 | 4.14x |
| 92202 | Extended examination of eye with drawing of optic nerve and surrounding area (macula) | 4.9K | $66.9K | $13.66 | 3.87x |
| 92133 | Diagnostic imaging of optic nerve of eye | 2.0K | $62.4K | $31.54 | 4.06x |
| Q5124 | Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg | 356 | $60.9K | $170.97 | 3.83x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 444 | $51.8K | $116.64 | 3.48x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 777 | $49.7K | $63.93 | 2.81x |
This provider submits charges 3.19 times higher than what Medicare actually pays.
A markup ratio of 3.19x means for every $100 Medicare pays, this provider initially charges $319. 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 MA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Torsten Wiegand, MD | Boston, MA | $49.8M | ✓ Clear |
| David Reed, M.D. | Plymouth, MA | $44.2M | ✓ Clear |
| Chirag Shah, MD | Boston, MA | $34.3M | ✓ 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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