This provider averages 55 services per working day
Based on 138.2K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $12.8M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 55 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 | $375.83 | $195.59 | 1.92x | $180.24 | $1.0M | 11.7K | 5.2K |
| 2015 | $404.49 | $192.76 | 2.10x | $211.73 | $1.1M | 12.6K | 5.2K |
| 2016 | $511.39 | $228.46 | 2.24x | $282.93 | $1.1M | 13.1K | 5.3K |
| 2017 | $376.25 | $187.64 | 2.01x | $188.61 | $1.2M | 13.8K | 5.5K |
| 2018 | $236.09 | $135.01 | 1.75x | $101.08 | $1.4M | 15.7K | 6.1K |
| 2019 | $304.53 | $143.77 | 2.12x | $160.76 | $1.5M | 16.1K | 5.9K |
| 2020 | $242.64 | $127.84 | 1.90x | $114.80 | $1.3M | 13.1K | 4.9K |
| 2021 | $382.94 | $131.78 | 2.91x | $251.16 | $1.6M | 15.2K | 5.4K |
| 2022 | $853.94 | $227.13 | 3.76x | $626.81 | $1.4M | 14.1K | 5.2K |
| 2023 | $935.71 | $251.71 | 3.72x | $684.00 | $1.3M | 12.8K | 4.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 5.5K | $4.1M | $739.38 | 1.85x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 34.7K | $3.6M | $104.70 | 1.83x |
| 92134 | Diagnostic imaging of retina | 34.6K | $1.3M | $37.18 | 4.26x |
| 67028 | Injection of drug into eye | 11.9K | $1.2M | $97.87 | 5.14x |
| J2778 | Injection, ranibizumab, 0.1 mg | 1.9K | $494.0K | $266.87 | 2.09x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 20.5K | $458.2K | $22.31 | 2.12x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.0K | $295.2K | $100.07 | 2.01x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.7K | $226.2K | $134.58 | 1.73x |
| J3590 | Unclassified biologics | 95 | $204.6K | $2.2K | 3.26x |
| J9035 | Injection, bevacizumab, 10 mg | 3.3K | $189.8K | $57.23 | 1.78x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 1.9K | $172.6K | $92.23 | 2.59x |
| 92202 | Extended examination of eye with drawing of optic nerve and surrounding area (macula) | 12.1K | $167.6K | $13.89 | 5.91x |
| 92250 | Photography of the retina | 2.0K | $116.6K | $57.15 | 2.18x |
| 67041 | Removal of membrane from the retina | 72 | $77.6K | $1.1K | 2.52x |
| 92201 | Extended examination of eye with drawing of retina | 2.1K | $44.5K | $20.91 | 4.01x |
| J7999 | Compounded drug, not otherwise classified | 603 | $41.2K | $68.28 | 5.69x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 248 | $28.8K | $116.25 | 2.36x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 1.1K | $26.7K | $24.31 | 2.15x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 122 | $19.2K | $157.55 | 2.02x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 171 | $12.8K | $75.12 | 1.87x |
This provider submits charges 2.53 times higher than what Medicare actually pays.
A markup ratio of 2.53x means for every $100 Medicare pays, this provider initially charges $253. 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 |
|---|---|---|---|
| Michael Elman, M.D. | Baltimore, MD | $68.5M | ✓ Clear |
| 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 |
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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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