This provider averages 169 services per working day
Based on 421.9K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $68.5M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 169 services per working day raises questions about billing patterns.
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 | $551.36 | $179.38 | 3.07x | $371.98 | $5.4M | 30.3K | 17 |
| 2015 | $587.31 | $188.59 | 3.11x | $398.72 | $5.5M | 29.3K | 18 |
| 2016 | $576.66 | $181.36 | 3.18x | $395.30 | $5.2M | 28.6K | 21 |
| 2017 | $661.29 | $202.83 | 3.26x | $458.46 | $7.6M | 37.6K | 17 |
| 2018 | $664.29 | $204.91 | 3.24x | $459.38 | $9.1M | 44.3K | 18 |
| 2019 | $657.52 | $195.36 | 3.37x | $462.16 | $8.8M | 45.2K | 17 |
| 2020 | $684.00 | $195.25 | 3.50x | $488.75 | $8.2M | 42.0K | 17 |
| 2021 | $677.61 | $188.91 | 3.59x | $488.70 | $7.9M | 41.9K | 21 |
| 2022 | $485.94 | $131.09 | 3.71x | $354.85 | $7.0M | 53.0K | 21 |
| 2023 | $204.09 | $53.81 | 3.79x | $150.28 | $3.7M | 69.6K | 21 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2778 | Injection, ranibizumab, 0.1 mg | 136.6K | $37.4M | $273.47 | 3.66x |
| J0178 | Injection, aflibercept, 1 mg | 17.6K | $12.9M | $735.23 | 3.68x |
| 92014 | Established patient complete exam of visual system | 43.4K | $4.4M | $102.14 | 1.55x |
| 67028 | Injection of drug into eye | 39.4K | $3.6M | $92.70 | 3.65x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 70.6K | $2.1M | $29.19 | 3.43x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 19.3K | $1.6M | $84.68 | 3.07x |
| 92134 | Imaging of retina | 41.9K | $1.5M | $34.86 | 2.44x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 10.3K | $1.1M | $107.35 | 1.65x |
| J3590 | Unclassified biologics | 528 | $925.6K | $1.8K | 3.38x |
| 92250 | Photography of the retina | 15.7K | $756.8K | $48.24 | 1.98x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 4.4K | $692.3K | $156.24 | 3.65x |
| 92012 | Established patient problem focused exam of visual system | 9.3K | $678.7K | $72.89 | 1.48x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 2.2K | $295.4K | $132.43 | 1.68x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 2.3K | $178.8K | $77.49 | 1.55x |
| 92083 | Exam of visual field with extended testing | 1.2K | $60.1K | $51.04 | 2.40x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 435 | $52.4K | $120.36 | 2.99x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 2.2K | $50.5K | $23.12 | 2.62x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 191 | $36.2K | $189.78 | 1.91x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 1.9K | $34.7K | $18.65 | 2.75x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 184 | $28.4K | $154.48 | 1.60x |
This provider submits charges 3.38 times higher than what Medicare actually pays.
A markup ratio of 3.38x means for every $100 Medicare pays, this provider initially charges $338. 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 MD for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| 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 |
| Joseph Schwartz, M.D. | Salisbury, MD | $44.0M | ✓ 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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