This provider's $20.2M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Their average markup ratio of 8.09x is significantly above the specialty median of 2.9x.
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 | $1.7K | $233.45 | 7.12x | $1.4K | $2.1M | 12.3K | 10.6K |
| 2015 | $1.6K | $236.02 | 6.88x | $1.4K | $2.0M | 12.3K | 10.4K |
| 2016 | $1.9K | $250.22 | 7.53x | $1.6K | $2.5M | 12.3K | 10.1K |
| 2017 | $2.0K | $281.53 | 6.99x | $1.7K | $2.4M | 12.6K | 10.4K |
| 2018 | $2.1K | $277.75 | 7.47x | $1.8K | $2.3M | 12.3K | 10.2K |
| 2019 | $1.8K | $259.22 | 7.01x | $1.6K | $2.1M | 12.7K | 10.4K |
| 2020 | $1.7K | $235.50 | 7.39x | $1.5K | $1.4M | 8.4K | 7.0K |
| 2021 | $1.5K | $215.57 | 6.80x | $1.2K | $1.8M | 10.2K | 8.1K |
| 2022 | $1.6K | $216.74 | 7.16x | $1.3K | $1.7M | 10.1K | 8.2K |
| 2023 | $1.5K | $232.92 | 6.48x | $1.3K | $1.9M | 10.3K | 8.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 16.3K | $7.6M | $466.27 | 10.56x |
| 66982 | Removal of cataract with insertion of lens | 4.7K | $2.7M | $584.62 | 9.36x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 4.2K | $1.2M | $291.90 | 8.05x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 4.8K | $1.1M | $232.69 | 10.10x |
| 0191T | Internal insertion of eye fluid drainage device | 1.6K | $1.0M | $655.25 | 8.39x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 10.6K | $1.0M | $96.09 | 1.82x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 7.5K | $945.8K | $125.44 | 1.68x |
| 65820 | Incision to improve eye fluid flow | 972 | $711.8K | $732.26 | 2.05x |
| 66172 | Creation of eye fluid drainage tract | 608 | $699.0K | $1.1K | 4.78x |
| 66761 | Creation of eye fluid drainage tracts in iris using laser, per session | 2.6K | $687.6K | $261.94 | 8.97x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.7K | $468.0K | $99.31 | 1.76x |
| 92083 | Measurement of field of vision during daylight conditions | 6.8K | $377.0K | $55.24 | 2.72x |
| 92020 | Examination of cornea and iris using lens device and slit lamp | 12.5K | $294.0K | $23.47 | 3.41x |
| 92133 | Diagnostic imaging of optic nerve of eye | 9.6K | $222.3K | $23.10 | 10.83x |
| 92136 | Measurement of corneal curvature and depth of eye | 5.6K | $183.3K | $32.50 | 6.43x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 4.4K | $112.2K | $25.37 | 4.60x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 4.1K | $98.7K | $24.08 | 4.87x |
| 66986 | Exchange of lens prosthesis | 119 | $94.9K | $797.28 | 3.76x |
| 65875 | Removal of scar tissue in eye | 217 | $68.2K | $314.08 | 7.16x |
| 66180 | Creation of shunt to improve eye fluid flow | 110 | $55.0K | $500.42 | 14.99x |
This provider submits charges 8.09 times higher than what Medicare actually pays.
A markup ratio of 8.09x means for every $100 Medicare pays, this provider initially charges $809. 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 NJ for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Howard Fine, MD MHSC | New Brunswick, NJ | $44.5M | ✓ Clear |
| Robert Barone, MD | Newton, NJ | $43.3M | ✓ Clear |
| Jonathan Prenner, MD | New Brunswick, NJ | $43.1M | ✓ Clear |
| Sumit Shah, M.D. | New Brunswick, NJ | $37.0M | ✓ Clear |
| David Kim, M.D. | Union, NJ | $36.1M | ✓ Clear |
Share this provider's Medicare payment information
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.
Believe this data is inaccurate? Dispute this data