This provider's $4.4M in total Medicare payments ranks in the 96th percentile of Ophthalmology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $485.19 | $152.34 | 3.18x | $332.85 | $417.7K | 6.0K | 4.9K |
| 2015 | $247.85 | $97.58 | 2.54x | $150.27 | $432.1K | 7.0K | 5.8K |
| 2016 | $368.22 | $152.19 | 2.42x | $216.03 | $451.2K | 7.0K | 5.5K |
| 2017 | $415.88 | $153.22 | 2.71x | $262.66 | $434.9K | 7.1K | 5.7K |
| 2018 | $195.86 | $66.29 | 2.95x | $129.57 | $386.6K | 6.7K | 5.4K |
| 2019 | $191.08 | $67.07 | 2.85x | $124.01 | $402.7K | 6.8K | 6.0K |
| 2020 | $302.56 | $58.01 | 5.22x | $244.55 | $451.7K | 6.4K | 4.6K |
| 2021 | $334.08 | $78.68 | 4.25x | $255.40 | $457.4K | 7.7K | 5.5K |
| 2022 | $357.41 | $80.49 | 4.44x | $276.92 | $460.9K | 8.0K | 5.8K |
| 2023 | $352.96 | $76.41 | 4.62x | $276.55 | $536.8K | 9.2K | 6.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 9.8K | $1.1M | $109.51 | 2.53x |
| 92083 | Measurement of field of vision during daylight conditions | 9.0K | $503.5K | $56.16 | 3.86x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.2K | $422.7K | $100.58 | 3.36x |
| 92250 | Photography of the retina | 8.7K | $406.3K | $46.72 | 5.98x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 5.0K | $375.1K | $75.05 | 2.61x |
| 92133 | Diagnostic imaging of optic nerve of eye | 8.6K | $290.7K | $33.94 | 4.40x |
| 92134 | Diagnostic imaging of retina | 5.0K | $182.7K | $36.83 | 3.36x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.3K | $180.0K | $139.76 | 2.78x |
| 99443 | Physician telephone patient service, 21-30 minutes of medical discussion | 1.7K | $175.1K | $103.59 | 3.38x |
| 92020 | Examination of cornea and iris using lens device and slit lamp | 7.1K | $168.4K | $23.86 | 4.85x |
| 92025 | Computerized mapping of corneal curvature | 2.7K | $81.2K | $30.03 | 5.00x |
| 68810 | Insertion of probe into the tear duct | 319 | $71.5K | $224.06 | 3.02x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 2.8K | $59.9K | $21.60 | 2.76x |
| 99442 | Physician telephone patient service, 11-20 minutes of medical discussion | 757 | $57.9K | $76.52 | 3.92x |
| 68761 | Closure of tear duct opening using plug | 565 | $52.6K | $93.11 | 5.48x |
| 99215 | Established patient outpatient visit, total time 40-54 minutes | 296 | $45.3K | $153.14 | 2.29x |
| 67904 | Repair of tendon of upper eyelid | 46 | $43.5K | $945.82 | 1.96x |
| 66984 | Removal of cataract with insertion of lens | 68 | $37.9K | $556.82 | 3.06x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 247 | $31.7K | $128.27 | 1.95x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 426 | $30.1K | $70.60 | 5.31x |
This provider submits charges 3.56 times higher than what Medicare actually pays.
A markup ratio of 3.56x means for every $100 Medicare pays, this provider initially charges $356. 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 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 |
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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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