This provider averages 88 services per working day
Based on 218.9K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $27.1M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 88 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 71% from 2014 to 2023.
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 | $223.21 | $79.55 | 2.81x | $143.66 | $1.8M | 22.6K | 35 |
| 2015 | $264.28 | $96.01 | 2.75x | $168.27 | $2.1M | 21.5K | 33 |
| 2016 | $261.50 | $99.51 | 2.63x | $161.99 | $2.4M | 24.5K | 33 |
| 2017 | $268.10 | $110.11 | 2.43x | $157.99 | $3.1M | 27.7K | 33 |
| 2018 | $371.63 | $152.64 | 2.43x | $218.99 | $3.4M | 22.2K | 35 |
| 2019 | $364.10 | $148.46 | 2.45x | $215.64 | $3.3M | 21.9K | 31 |
| 2020 | $355.13 | $143.33 | 2.48x | $211.80 | $2.6M | 18.2K | 28 |
| 2021 | $340.51 | $137.06 | 2.48x | $203.45 | $2.5M | 18.5K | 27 |
| 2022 | $342.15 | $133.92 | 2.55x | $208.23 | $2.8M | 21.1K | 27 |
| 2023 | $389.99 | $149.53 | 2.61x | $240.46 | $3.1M | 20.6K | 29 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 20.0K | $14.8M | $740.15 | 2.12x |
| 66984 | Removal of cataract with insertion of prosthetic lens | 3.4K | $1.7M | $496.90 | 4.26x |
| 92014 | Established patient complete exam of visual system | 16.3K | $1.4M | $84.21 | 2.53x |
| 67028 | Injection of drug into eye | 14.8K | $1.2M | $83.88 | 6.42x |
| 92134 | Imaging of retina | 37.4K | $1.2M | $32.75 | 2.24x |
| 92012 | Established patient problem focused exam of visual system | 18.4K | $1.2M | $64.46 | 2.32x |
| 66982 | Complex removal of cataract with insertion of prosthetic lens | 1.0K | $669.8K | $639.76 | 3.31x |
| 66821 | Removal of recurring cataract in lens capsule using a laser | 1.7K | $466.4K | $269.28 | 2.09x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 4.1K | $442.1K | $108.43 | 2.55x |
| 83861 | Microfluid analysis of tears | 17.4K | $383.9K | $22.08 | 1.59x |
| 92083 | Exam of visual field with extended testing | 7.9K | $380.9K | $48.44 | 2.31x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 1.9K | $301.1K | $156.98 | 2.04x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 5.0K | $283.6K | $56.95 | 2.29x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 3.0K | $280.5K | $92.85 | 2.32x |
| 92133 | Imaging of optic nerve | 7.4K | $222.2K | $29.84 | 2.32x |
| 92136 | Measurement of corneal curvature and depth of eye | 5.0K | $220.5K | $44.44 | 2.42x |
| 83516 | Analysis of substance using immunoassay technique, multiple step method | 17.0K | $206.1K | $12.13 | 2.06x |
| J3490 | Unclassified drugs | 110 | $194.1K | $1.8K | 2.02x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 2.2K | $190.7K | $85.87 | 2.45x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 1.2K | $139.0K | $120.36 | 2.64x |
This provider submits charges 2.54 times higher than what Medicare actually pays.
A markup ratio of 2.54x means for every $100 Medicare pays, this provider initially charges $254. 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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