This provider averages 58 services per working day
Based on 129.6K total services over 9 years (250 working days/year). Learn about impossible service volumes →
This provider's $39.1M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 58 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 102% from 2015 to 2023.
84% of their billing comes from a single procedure code (J0178 — Injection, aflibercept, 1 mg).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 84% in 2016
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 |
|---|---|---|---|---|---|---|---|
| 2015 | $550.90 | $282.76 | 1.95x | $268.14 | $2.3M | 8.2K | 14 |
| 2016 | $550.81 | $284.70 | 1.93x | $266.11 | $4.2M | 14.9K | 16 |
| 2017 | $596.86 | $314.52 | 1.90x | $282.34 | $4.6M | 14.7K | 15 |
| 2018 | $594.50 | $312.12 | 1.90x | $282.38 | $4.7M | 15.0K | 15 |
| 2019 | $609.05 | $317.44 | 1.92x | $291.61 | $5.0M | 15.7K | 13 |
| 2020 | $632.18 | $331.47 | 1.91x | $300.71 | $4.4M | 13.4K | 12 |
| 2021 | $642.64 | $332.98 | 1.93x | $309.66 | $4.7M | 14.2K | 13 |
| 2022 | $617.89 | $311.73 | 1.98x | $306.16 | $4.4M | 14.0K | 15 |
| 2023 | $502.99 | $239.82 | 2.10x | $263.17 | $4.7M | 19.5K | 15 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 44.3K | $32.6M | $737.12 | 1.63x |
| 67028 | Injection of drug into eye | 23.1K | $2.0M | $84.80 | 6.39x |
| J2778 | Injection, ranibizumab, 0.1 mg | 4.5K | $1.2M | $268.77 | 1.86x |
| 92012 | Established patient problem focused exam of visual system | 15.9K | $980.9K | $61.70 | 1.72x |
| 92134 | Imaging of retina | 21.1K | $636.6K | $30.21 | 1.99x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 2.3K | $366.4K | $157.58 | 1.43x |
| 67210 | Destruction of growth of retina using a laser | 581 | $219.2K | $377.33 | 5.58x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 2.7K | $204.3K | $76.65 | 2.35x |
| 92250 | Photography of the retina | 5.1K | $178.7K | $35.13 | 2.90x |
| J9035 | Injection, bevacizumab, 10 mg | 2.6K | $144.0K | $55.59 | 1.80x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 4.0K | $114.1K | $28.81 | 1.82x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 735 | $88.5K | $120.36 | 3.88x |
| 92014 | Established patient complete exam of visual system | 1.1K | $87.3K | $81.71 | 1.87x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 310 | $81.0K | $261.34 | 7.79x |
| 76512 | 2d ultrasound scan of eye tissue and structures | 999 | $54.0K | $54.03 | 9.49x |
| 67145 | Preventive retinal detachment treatment by heat or laser, 1 or more sessions | 146 | $54.0K | $369.65 | 4.28x |
| 67110 | Repair of detached retina by injection of air or gas | 34 | $20.6K | $605.02 | 1.98x |
| 92240 | Imaging of blood vessels in back of eye using indocyanine-green dye | 26 | $4.0K | $153.12 | 2.66x |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 54 | $2.1K | $39.25 | 1.67x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 16 | $2.0K | $124.88 | 1.67x |
This provider submits charges 1.95 times higher than what Medicare actually pays.
A markup ratio of 1.95x means for every $100 Medicare pays, this provider initially charges $195. 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 NY for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Jonathan Jonisch, MD | Great Neck, NY | $52.3M | ✓ Clear |
| Jeffrey Josef, M.D. | Suffern, NY | $52.2M | ✓ Clear |
| Brett Rosenblatt | Great Neck, NY | $50.0M | ✓ Clear |
| Kenneth Graham | Great Neck, NY | $47.1M | ✓ Clear |
| Glenn Stoller, M.D. | Rockville Centre, NY | $46.4M | ✓ 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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