This provider's $17.4M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 7987% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 473% in 2016
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 | $274.20 | $53.07 | 5.17x | $221.13 | $46.5K | 877 | 3 |
| 2015 | $261.43 | $43.52 | 6.01x | $217.91 | $37.0K | 850 | 3 |
| 2016 | $376.75 | $146.15 | 2.58x | $230.60 | $212.1K | 1.5K | 15 |
| 2017 | $403.63 | $160.42 | 2.52x | $243.21 | $869.6K | 5.4K | 20 |
| 2018 | $416.34 | $208.25 | 2.00x | $208.09 | $1.7M | 8.2K | 20 |
| 2019 | $445.15 | $226.61 | 1.96x | $218.54 | $2.4M | 10.7K | 22 |
| 2020 | $464.49 | $235.31 | 1.97x | $229.18 | $2.6M | 10.9K | 26 |
| 2021 | $566.77 | $246.74 | 2.30x | $320.03 | $1.7M | 6.8K | 19 |
| 2022 | $440.06 | $186.39 | 2.36x | $253.67 | $4.1M | 22.1K | 24 |
| 2023 | $161.54 | $66.87 | 2.42x | $94.67 | $3.8M | 56.3K | 23 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 12.4K | $9.0M | $727.62 | 2.12x |
| J2778 | Injection, ranibizumab, 0.1 mg | 12.2K | $2.7M | $223.57 | 1.93x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 50.5K | $1.5M | $28.89 | 2.48x |
| 67028 | Injection of drug into eye | 12.0K | $1.0M | $86.03 | 3.30x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 3.7K | $580.5K | $155.60 | 1.81x |
| 92014 | Established patient complete exam of visual system | 4.3K | $355.1K | $82.17 | 2.28x |
| 92134 | Imaging of retina | 12.5K | $347.3K | $27.72 | 2.51x |
| J3590 | Unclassified biologics | 433 | $289.3K | $668.07 | 2.66x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 3.3K | $256.9K | $78.26 | 2.28x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 216 | $187.9K | $869.69 | 2.38x |
| 92004 | New patient complete exam of visual system | 1.5K | $140.9K | $96.69 | 2.29x |
| J9035 | Injection, bevacizumab, 10 mg | 2.4K | $139.2K | $56.99 | 3.20x |
| 67041 | Removal of membrane of retina | 157 | $138.7K | $883.28 | 2.49x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1.7K | $89.5K | $51.91 | 2.38x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 354 | $88.8K | $250.83 | 1.66x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 355 | $87.8K | $247.45 | 5.42x |
| 67113 | Complex repair of detached retina and drainage of eye fluid between lens and retina | 80 | $80.8K | $1.0K | 2.66x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 236 | $79.3K | $336.03 | 2.37x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 649 | $76.3K | $117.51 | 2.08x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 88 | $59.0K | $670.57 | 2.31x |
This provider submits charges 2.24 times higher than what Medicare actually pays.
A markup ratio of 2.24x means for every $100 Medicare pays, this provider initially charges $224. 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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