This provider averages 55 services per working day
Based on 136.7K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $24.5M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 55 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 151% from 2014 to 2023.
66% 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 | $240.78 | $140.94 | 1.71x | $99.84 | $1.4M | 10.0K | 15 |
| 2015 | $260.90 | $151.34 | 1.72x | $109.56 | $1.8M | 11.8K | 20 |
| 2016 | $294.77 | $171.71 | 1.72x | $123.06 | $1.7M | 10.1K | 15 |
| 2017 | $301.07 | $171.72 | 1.75x | $129.35 | $2.2M | 12.6K | 17 |
| 2018 | $344.90 | $195.13 | 1.77x | $149.77 | $2.6M | 13.2K | 16 |
| 2019 | $354.71 | $203.38 | 1.74x | $151.33 | $3.0M | 14.7K | 14 |
| 2020 | $371.50 | $211.52 | 1.76x | $159.98 | $2.8M | 13.0K | 13 |
| 2021 | $538.09 | $229.75 | 2.34x | $308.34 | $2.8M | 12.3K | 17 |
| 2022 | $759.80 | $224.44 | 3.39x | $535.36 | $2.7M | 12.2K | 15 |
| 2023 | $565.20 | $131.28 | 4.31x | $433.92 | $3.5M | 26.9K | 21 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 21.7K | $16.0M | $735.18 | 2.08x |
| 92014 | Established patient complete exam of visual system | 22.5K | $2.1M | $94.46 | 2.11x |
| 67028 | Injection of drug into eye | 17.4K | $1.6M | $92.00 | 4.13x |
| J2778 | Injection, ranibizumab, 0.1 mg | 5.5K | $1.5M | $268.87 | 2.24x |
| 92134 | Imaging of retina | 28.4K | $973.8K | $34.30 | 3.60x |
| 92012 | Established patient problem focused exam of visual system | 6.1K | $423.9K | $69.32 | 1.68x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 12.3K | $355.4K | $28.90 | 4.33x |
| J9035 | Injection, bevacizumab, 10 mg | 5.2K | $301.7K | $57.98 | 1.42x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 2.6K | $263.1K | $100.97 | 2.53x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.7K | $220.0K | $126.01 | 1.99x |
| 92250 | Photography of the retina | 3.6K | $148.1K | $41.51 | 3.74x |
| J7999 | Compounded drug, not otherwise classified | 1.5K | $106.6K | $72.84 | 7.64x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1.2K | $76.3K | $63.08 | 2.15x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 802 | $67.3K | $83.92 | 2.80x |
| J3490 | Unclassified drugs | 35 | $61.9K | $1.8K | 3.32x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 435 | $52.4K | $120.36 | 3.05x |
| 92004 | New patient complete exam of visual system | 409 | $45.5K | $111.36 | 3.42x |
| 92499 | Service or surgery of the eye | 1.2K | $44.2K | $37.27 | 2.70x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 37 | $34.8K | $939.81 | 3.03x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 141 | $27.9K | $198.05 | 5.01x |
This provider submits charges 2.37 times higher than what Medicare actually pays.
A markup ratio of 2.37x means for every $100 Medicare pays, this provider initially charges $237. 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 MD for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Michael Elman, M.D. | Baltimore, MD | $68.5M | ✓ Clear |
| David Warrow, M.D. | Hagerstown, MD | $65.5M | ✓ Clear |
| Raymond Sjaarda, M.D. | Baltimore, MD | $47.2M | ✓ Clear |
| Allen Hu, MD | Hagerstown, MD | $45.7M | ✓ Clear |
| James Rial, M.D. | Salisbury, MD | $45.2M | ✓ 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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