This provider's $5.6M in total Medicare payments ranks in the 97th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 311% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 125% in 2015
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 | $197.07 | $77.44 | 2.54x | $119.63 | $173.6K | 2.4K | 1.7K |
| 2015 | $315.63 | $133.82 | 2.36x | $181.81 | $390.6K | 5.1K | 2.8K |
| 2016 | $366.79 | $116.50 | 3.15x | $250.29 | $333.4K | 4.2K | 2.3K |
| 2017 | $363.63 | $114.45 | 3.18x | $249.18 | $431.2K | 5.7K | 2.8K |
| 2018 | $315.14 | $101.73 | 3.10x | $213.41 | $545.8K | 7.1K | 4.3K |
| 2019 | $353.53 | $131.25 | 2.69x | $222.28 | $731.2K | 9.5K | 5.5K |
| 2020 | $348.54 | $123.47 | 2.82x | $225.07 | $656.9K | 8.9K | 5.1K |
| 2021 | $277.74 | $130.89 | 2.12x | $146.85 | $856.3K | 10.3K | 6.0K |
| 2022 | $256.11 | $115.23 | 2.22x | $140.88 | $763.5K | 9.3K | 4.8K |
| 2023 | $215.71 | $94.57 | 2.28x | $121.14 | $713.2K | 8.7K | 4.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 21.6K | $2.0M | $93.37 | 1.62x |
| 92134 | Diagnostic imaging of retina | 16.5K | $535.8K | $32.51 | 3.08x |
| J0178 | Injection, aflibercept, 1 mg | 669 | $460.3K | $688.10 | 1.70x |
| 92242 | Imaging of blood vessels in back of eye using fluorescein and indocyanine-green dye | 2.0K | $402.8K | $204.55 | 2.54x |
| 67028 | Injection of drug into eye | 4.1K | $363.2K | $88.06 | 5.33x |
| 92250 | Photography of the retina | 7.5K | $271.0K | $36.36 | 3.53x |
| J7999 | Compounded drug, not otherwise classified | 2.9K | $196.3K | $68.09 | 1.63x |
| 92083 | Measurement of field of vision during daylight conditions | 3.2K | $161.0K | $50.97 | 2.65x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 1.5K | $154.3K | $101.25 | 1.98x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 353 | $150.6K | $426.70 | 2.96x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 1.6K | $138.5K | $86.96 | 2.87x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 477 | $131.4K | $275.50 | 1.71x |
| 92240 | Examination of eye using an endoscope | 419 | $89.6K | $213.92 | 1.96x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 1.1K | $75.4K | $70.36 | 1.78x |
| 92273 | Full field recording of retinal electrical responses to external stimuli with interpretation and report | 674 | $75.2K | $111.52 | 2.24x |
| 92082 | Measurement of field of vision during daylight conditions | 2.0K | $74.5K | $36.49 | 2.96x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 214 | $72.9K | $340.68 | 3.95x |
| 95930 | Measurement and recording of nerve conduction patterns using visually-evoked stimulation | 969 | $56.3K | $58.14 | 5.26x |
| 67515 | Injection of medication or substance into membrane covering eyeball | 692 | $42.7K | $61.65 | 2.60x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 135 | $27.4K | $202.77 | 2.37x |
This provider submits charges 2.4 times higher than what Medicare actually pays.
A markup ratio of 2.4x means for every $100 Medicare pays, this provider initially charges $240. 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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