This provider's $5.2M 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 | $192.33 | $112.63 | 1.71x | $79.70 | $530.5K | 7.7K | 5.7K |
| 2015 | $199.99 | $111.73 | 1.79x | $88.26 | $521.7K | 7.2K | 5.6K |
| 2016 | $205.11 | $108.24 | 1.89x | $96.87 | $488.9K | 7.3K | 5.6K |
| 2017 | $220.74 | $108.58 | 2.03x | $112.16 | $482.4K | 7.2K | 5.4K |
| 2018 | $283.50 | $144.42 | 1.96x | $139.08 | $564.7K | 7.5K | 5.7K |
| 2019 | $263.92 | $118.80 | 2.22x | $145.12 | $585.0K | 7.8K | 6.1K |
| 2020 | $277.22 | $142.03 | 1.95x | $135.19 | $480.4K | 7.0K | 5.7K |
| 2021 | $258.64 | $134.62 | 1.92x | $124.02 | $539.4K | 7.8K | 6.2K |
| 2022 | $257.50 | $144.11 | 1.79x | $113.39 | $506.8K | 7.6K | 6.0K |
| 2023 | $230.73 | $126.31 | 1.83x | $104.42 | $516.4K | 7.6K | 5.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 92083 | Measurement of field of vision during daylight conditions | 15.9K | $869.2K | $54.57 | 1.92x |
| 66984 | Removal of cataract with insertion of lens | 1.4K | $743.3K | $537.08 | 2.08x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 8.1K | $585.7K | $72.19 | 1.58x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 5.5K | $537.8K | $97.51 | 1.72x |
| 92133 | Diagnostic imaging of optic nerve of eye | 10.7K | $350.1K | $32.81 | 2.29x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.5K | $346.6K | $63.59 | 1.63x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.0K | $345.7K | $85.35 | 1.70x |
| 92250 | Photography of the retina | 5.1K | $197.4K | $38.88 | 2.57x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.5K | $174.9K | $120.29 | 1.74x |
| 92020 | Examination of cornea and iris using lens device and slit lamp | 6.8K | $166.7K | $24.68 | 2.23x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 548 | $136.4K | $248.82 | 1.81x |
| 92134 | Diagnostic imaging of retina | 3.4K | $121.8K | $36.24 | 2.07x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 323 | $96.3K | $298.28 | 1.36x |
| 67028 | Injection of drug into eye | 870 | $79.1K | $90.93 | 2.53x |
| 92136 | Measurement of corneal curvature and depth of eye | 1.3K | $66.9K | $51.90 | 2.41x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 719 | $66.7K | $92.74 | 2.09x |
| 0191T | Internal insertion of eye fluid drainage device | 136 | $60.9K | $447.85 | 2.37x |
| 95930 | Measurement and recording of nerve conduction patterns using visually-evoked stimulation | 533 | $58.1K | $108.93 | 1.80x |
| J9035 | Injection, bevacizumab, 10 mg | 719 | $42.1K | $58.49 | 2.05x |
| 65820 | Incision to improve eye fluid flow | 46 | $34.6K | $752.70 | 1.47x |
This provider submits charges 1.91 times higher than what Medicare actually pays.
A markup ratio of 1.91x means for every $100 Medicare pays, this provider initially charges $191. This is lower 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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