This provider's $11.0M in total Medicare payments ranks in the 98th 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.
Notable: Payments increased 52% 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 | $832.62 | $337.71 | 2.47x | $494.91 | $1.0M | 11.5K | 5.3K |
| 2015 | $868.04 | $324.01 | 2.68x | $544.03 | $935.2K | 10.2K | 4.9K |
| 2016 | $697.93 | $223.65 | 3.12x | $474.28 | $706.6K | 8.9K | 4.7K |
| 2017 | $696.67 | $246.39 | 2.83x | $450.28 | $944.9K | 10.0K | 5.4K |
| 2018 | $661.10 | $236.28 | 2.80x | $424.82 | $1.4M | 13.3K | 6.3K |
| 2019 | $752.89 | $270.22 | 2.79x | $482.67 | $1.5M | 15.1K | 7.3K |
| 2020 | $835.26 | $309.33 | 2.70x | $525.93 | $1.1M | 10.2K | 4.8K |
| 2021 | $603.00 | $230.67 | 2.61x | $372.33 | $1.0M | 10.4K | 4.3K |
| 2022 | $668.39 | $242.71 | 2.75x | $425.68 | $1.2M | 13.0K | 5.7K |
| 2023 | $614.49 | $232.47 | 2.64x | $382.02 | $1.1M | 12.3K | 5.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2778 | Injection, ranibizumab, 0.1 mg | 7.8K | $2.0M | $257.05 | 2.74x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 15.3K | $1.3M | $82.43 | 2.86x |
| 67028 | Injection of drug into eye | 14.6K | $1.2M | $84.47 | 5.41x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 10.7K | $1.1M | $100.25 | 2.66x |
| 92134 | Diagnostic imaging of retina | 21.3K | $709.8K | $33.34 | 2.71x |
| 92250 | Photography of the retina | 14.2K | $527.7K | $37.20 | 3.01x |
| 92242 | Imaging of blood vessels in back of eye using fluorescein and indocyanine-green dye | 2.6K | $495.8K | $191.13 | 2.70x |
| J0178 | Injection, aflibercept, 1 mg | 614 | $453.5K | $738.59 | 2.63x |
| 99213 | Established patient outpatient visit, total time 20-29 minutes | 5.3K | $377.5K | $71.73 | 2.66x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 321 | $365.5K | $1.1K | 2.57x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 768 | $328.0K | $427.07 | 2.57x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 4.2K | $292.5K | $69.13 | 2.66x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 580 | $291.8K | $503.16 | 3.57x |
| J9035 | Injection, bevacizumab, 10 mg | 4.5K | $240.6K | $53.75 | 1.67x |
| 67042 | Removal of membrane from the retina, pars plana approach | 241 | $236.7K | $982.07 | 2.60x |
| 92240 | Examination of eye using an endoscope | 1.1K | $211.4K | $199.40 | 2.28x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.3K | $171.2K | $75.91 | 2.78x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 494 | $128.5K | $260.11 | 2.61x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 1.1K | $126.4K | $119.05 | 2.69x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 770 | $86.6K | $112.46 | 2.89x |
This provider submits charges 3.01 times higher than what Medicare actually pays.
A markup ratio of 3.01x means for every $100 Medicare pays, this provider initially charges $301. 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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