This provider's $26.4M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 311% from 2014 to 2023.
73% of their billing comes from a single procedure code (J0178 — Injection, aflibercept, 1 mg).
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 | $283.12 | $146.36 | 1.93x | $136.76 | $895.5K | 6.1K | 15 |
| 2015 | $291.87 | $151.58 | 1.93x | $140.29 | $1.1M | 7.0K | 16 |
| 2016 | $343.21 | $181.78 | 1.89x | $161.43 | $1.5M | 8.4K | 17 |
| 2017 | $366.12 | $195.48 | 1.87x | $170.64 | $1.9M | 9.8K | 17 |
| 2018 | $415.43 | $226.53 | 1.83x | $188.90 | $2.8M | 12.1K | 13 |
| 2019 | $427.30 | $231.69 | 1.84x | $195.61 | $3.2M | 13.8K | 15 |
| 2020 | $472.28 | $257.99 | 1.83x | $214.29 | $3.6M | 14.1K | 12 |
| 2021 | $487.12 | $265.69 | 1.83x | $221.43 | $4.0M | 15.0K | 15 |
| 2022 | $486.67 | $256.91 | 1.89x | $229.76 | $3.8M | 14.6K | 13 |
| 2023 | $416.83 | $210.44 | 1.98x | $206.39 | $3.7M | 17.5K | 15 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 26.5K | $19.4M | $732.51 | 1.57x |
| 67028 | Injection of drug into eye | 20.3K | $1.8M | $89.63 | 4.55x |
| J2778 | Injection, ranibizumab, 0.1 mg | 5.8K | $1.5M | $259.47 | 1.62x |
| 92014 | Established patient complete exam of visual system | 13.8K | $1.2M | $87.51 | 1.83x |
| 92134 | Imaging of retina | 26.0K | $788.8K | $30.37 | 2.96x |
| J9035 | Injection, bevacizumab, 10 mg | 7.5K | $387.8K | $51.61 | 1.59x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 2.4K | $285.5K | $117.17 | 1.79x |
| 92250 | Photography of the retina | 6.1K | $218.1K | $36.02 | 3.61x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 200 | $186.1K | $930.38 | 2.47x |
| J3590 | Unclassified biologics | 3.2K | $162.5K | $50.36 | 1.29x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 2.0K | $94.6K | $48.29 | 2.80x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 94 | $88.6K | $942.09 | 2.92x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 3.1K | $88.2K | $28.82 | 1.77x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 112 | $45.0K | $401.83 | 3.00x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 109 | $44.7K | $409.96 | 4.82x |
| 92235 | Imaging of blood vessels in back of eye using fluorescein dye | 497 | $38.6K | $77.65 | 2.58x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 189 | $16.5K | $87.14 | 2.02x |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 193 | $14.6K | $75.60 | 2.05x |
| 92004 | New patient complete exam of visual system | 93 | $9.9K | $106.01 | 1.79x |
| 76512 | 2d ultrasound scan of eye tissue and structures | 166 | $9.2K | $55.55 | 2.70x |
This provider submits charges 1.88 times higher than what Medicare actually pays.
A markup ratio of 1.88x means for every $100 Medicare pays, this provider initially charges $188. 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 VA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Timothy Byrnes, MD | Roanoke, VA | $53.3M | ✓ Clear |
| James Tiedeman | Fishersville, VA | $51.1M | ✓ Clear |
| Juan Astruc, M.D. | Richmond, VA | $46.6M | ✓ Clear |
| Kapil Kapoor, MD | Norfolk, VA | $43.0M | ✓ Clear |
| Alan Wagner, MD | Norfolk, VA | $42.8M | ✓ 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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