This provider's $7.3M in total Medicare payments ranks in the 97th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 272% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 59% in 2018
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 | $445.91 | $139.77 | 3.19x | $306.14 | $351.2K | 4.1K | 2.8K |
| 2015 | $445.91 | $135.23 | 3.30x | $310.68 | $378.3K | 4.6K | 3.1K |
| 2016 | $350.87 | $110.73 | 3.17x | $240.14 | $393.9K | 4.9K | 3.2K |
| 2017 | $449.93 | $131.70 | 3.42x | $318.23 | $440.6K | 5.3K | 3.4K |
| 2018 | $433.92 | $132.11 | 3.28x | $301.81 | $701.8K | 6.6K | 3.7K |
| 2019 | $460.60 | $132.66 | 3.47x | $327.94 | $798.7K | 6.7K | 3.8K |
| 2020 | $419.59 | $123.71 | 3.39x | $295.88 | $855.2K | 7.2K | 3.8K |
| 2021 | $473.32 | $138.97 | 3.41x | $334.35 | $978.6K | 7.5K | 4.1K |
| 2022 | $429.38 | $122.82 | 3.50x | $306.56 | $1.1M | 8.5K | 4.6K |
| 2023 | $431.37 | $122.94 | 3.51x | $308.43 | $1.3M | 9.4K | 4.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 4.4K | $3.2M | $717.59 | 1.81x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 9.9K | $837.3K | $84.94 | 2.43x |
| 67028 | Injection of drug into eye | 7.7K | $698.4K | $91.19 | 6.03x |
| 66984 | Removal of cataract with insertion of lens | 1.1K | $523.3K | $455.47 | 4.61x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 7.0K | $436.5K | $62.44 | 2.27x |
| 92134 | Diagnostic imaging of retina | 14.7K | $433.5K | $29.40 | 2.72x |
| J9035 | Injection, bevacizumab, 10 mg | 3.1K | $166.3K | $54.05 | 1.85x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 1.5K | $160.4K | $104.81 | 2.34x |
| 66982 | Removal of cataract with insertion of lens | 243 | $151.0K | $621.47 | 3.98x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 577 | $146.9K | $254.59 | 5.05x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.9K | $133.1K | $45.14 | 2.68x |
| 92083 | Measurement of field of vision during daylight conditions | 3.0K | $131.7K | $43.31 | 3.46x |
| 92250 | Photography of the retina | 2.8K | $90.8K | $32.62 | 3.91x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 802 | $67.8K | $84.51 | 2.13x |
| 92136 | Measurement of corneal curvature and depth of eye | 1.4K | $54.4K | $38.59 | 3.78x |
| 92133 | Diagnostic imaging of optic nerve of eye | 1.6K | $40.7K | $25.05 | 3.19x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 295 | $17.8K | $60.23 | 2.94x |
| 92002 | Eye and medical examination for diagnosis and treatment, new patient | 235 | $13.0K | $55.51 | 2.48x |
| 66761 | Creation of eye fluid drainage tracts in iris using laser, per session | 37 | $8.8K | $238.41 | 6.06x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 235 | $7.2K | $30.80 | 2.35x |
This provider submits charges 2.8 times higher than what Medicare actually pays.
A markup ratio of 2.8x means for every $100 Medicare pays, this provider initially charges $280. This is higher than the national average.
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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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