This provider's $4.3M 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 | $322.79 | $91.01 | 3.55x | $231.78 | $451.1K | 5.3K | 3.4K |
| 2015 | $241.85 | $74.91 | 3.23x | $166.94 | $363.5K | 4.8K | 3.2K |
| 2016 | $332.00 | $78.29 | 4.24x | $253.71 | $421.9K | 5.6K | 3.9K |
| 2017 | $360.93 | $81.03 | 4.45x | $279.90 | $478.9K | 6.6K | 4.6K |
| 2018 | $250.54 | $69.66 | 3.60x | $180.88 | $444.3K | 5.9K | 4.0K |
| 2019 | $256.82 | $72.66 | 3.53x | $184.16 | $470.8K | 6.1K | 3.9K |
| 2020 | $306.36 | $89.79 | 3.41x | $216.57 | $489.2K | 6.1K | 3.7K |
| 2021 | $379.34 | $89.01 | 4.26x | $290.33 | $448.4K | 5.6K | 3.2K |
| 2022 | $397.33 | $89.64 | 4.43x | $307.69 | $385.5K | 4.9K | 2.8K |
| 2023 | $384.91 | $86.89 | 4.43x | $298.02 | $363.6K | 4.7K | 2.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 14.0K | $1.2M | $84.83 | 2.38x |
| 68761 | Closure of tear duct opening using plug | 11.9K | $991.8K | $83.37 | 2.88x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 3.9K | $774.4K | $196.31 | 3.03x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 951 | $236.9K | $249.10 | 5.65x |
| 92083 | Measurement of field of vision during daylight conditions | 5.2K | $235.1K | $44.89 | 3.54x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 3.3K | $195.2K | $59.83 | 1.86x |
| 92250 | Photography of the retina | 4.6K | $182.7K | $39.54 | 3.04x |
| 92133 | Diagnostic imaging of optic nerve of eye | 6.0K | $161.4K | $27.01 | 4.51x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 1.6K | $147.1K | $93.87 | 2.28x |
| 66984 | Removal of cataract with insertion of lens | 594 | $52.5K | $88.31 | 8.74x |
| 92134 | Diagnostic imaging of retina | 1.5K | $43.7K | $30.13 | 4.08x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 362 | $38.9K | $107.35 | 2.55x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 248 | $23.1K | $92.98 | 2.63x |
| 92020 | Examination of cornea and iris using lens device and slit lamp | 560 | $11.3K | $20.17 | 4.92x |
| 66761 | Creation of eye fluid drainage tracts in iris using laser, per session | 48 | $10.3K | $213.92 | 5.01x |
| 65210 | Removal of foreign body in external eye, conjunctiva or sclera | 126 | $6.0K | $47.38 | 2.87x |
| 68760 | Repair duct opening | 50 | $5.9K | $117.19 | 2.65x |
| 76514 | Ultrasound of corneal structure and measurement | 520 | $5.4K | $10.45 | 7.39x |
| 67800 | Removal of eyelid growth | 33 | $2.7K | $80.92 | 2.34x |
| 65222 | Removal of foreign body, external eye, cornea with slit lamp examination | 55 | $2.6K | $48.03 | 3.14x |
This provider submits charges 3.05 times higher than what Medicare actually pays.
A markup ratio of 3.05x means for every $100 Medicare pays, this provider initially charges $305. 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 NC for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Shil Patel, M.D. | New Bern, NC | $63.1M | ✓ Clear |
| James Pate, M.D. | Raleigh, NC | $44.5M | ✓ Clear |
| Justin Brown, M.D. | Charlotte, NC | $43.5M | ✓ Clear |
| Nitin Gupta, M.D., M.P.H. | Raleigh, NC | $42.0M | ✓ Clear |
| Igor Westra, MD | Wilmington, NC | $40.5M | ✓ 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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