This provider averages 52 services per working day
Based on 130.7K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $14.0M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 52 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 54% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 78% 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 | $1.1K | $245.45 | 4.41x | $837.63 | $695.5K | 8.4K | 5.0K |
| 2015 | $1.3K | $281.71 | 4.55x | $999.91 | $1.2M | 13.4K | 7.2K |
| 2016 | $1.5K | $275.74 | 5.32x | $1.2K | $1.5M | 16.5K | 8.7K |
| 2017 | $1.7K | $284.36 | 5.84x | $1.4K | $1.7M | 17.8K | 9.5K |
| 2018 | $1.5K | $264.56 | 5.83x | $1.3K | $1.7M | 17.3K | 9.3K |
| 2019 | $1.9K | $268.61 | 7.23x | $1.7K | $1.8M | 16.4K | 8.4K |
| 2020 | $1.5K | $254.81 | 5.79x | $1.2K | $1.6M | 13.0K | 6.8K |
| 2021 | $1.2K | $259.69 | 4.71x | $962.39 | $1.5M | 11.7K | 6.0K |
| 2022 | $453.32 | $195.70 | 2.32x | $257.62 | $1.1M | 8.4K | 4.2K |
| 2023 | $470.38 | $226.10 | 2.08x | $244.28 | $1.1M | 7.9K | 3.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 5.8K | $4.2M | $734.55 | 2.46x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 20.0K | $2.0M | $101.76 | 1.56x |
| 67028 | Injection of drug into eye | 13.7K | $1.1M | $83.31 | 6.49x |
| 92250 | Photography of the retina | 19.3K | $975.6K | $50.53 | 2.85x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 5.8K | $510.3K | $88.39 | 3.70x |
| 65800 | Aspiration of eye fluid | 4.8K | $486.4K | $102.01 | 7.22x |
| 92273 | Full field recording of retinal electrical responses to external stimuli with interpretation and report | 3.7K | $445.5K | $119.79 | 3.54x |
| J9035 | Injection, bevacizumab, 10 mg | 6.0K | $346.4K | $57.67 | 3.38x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 1.7K | $294.9K | $169.39 | 2.05x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 13.2K | $283.2K | $21.48 | 4.40x |
| 92242 | Imaging of blood vessels in back of eye using fluorescein and indocyanine-green dye | 1.2K | $277.1K | $223.27 | 3.45x |
| 92020 | Examination of cornea and iris using lens device and slit lamp | 11.0K | $249.3K | $22.69 | 3.00x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.8K | $227.3K | $129.00 | 1.63x |
| 76512 | Ultrasound of eye disease, growth, or structure | 3.2K | $209.2K | $65.29 | 5.08x |
| 92134 | Diagnostic imaging of retina | 5.6K | $201.4K | $36.20 | 3.53x |
| 67042 | Removal of membrane from the retina, pars plana approach | 192 | $196.3K | $1.0K | 8.18x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 430 | $195.1K | $453.68 | 8.23x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.4K | $162.7K | $119.62 | 1.72x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 130 | $160.1K | $1.2K | 8.03x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 912 | $140.6K | $154.16 | 1.57x |
This provider submits charges 3.42 times higher than what Medicare actually pays.
A markup ratio of 3.42x means for every $100 Medicare pays, this provider initially charges $342. 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 NJ for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Howard Fine, MD MHSC | New Brunswick, NJ | $44.5M | ✓ Clear |
| Robert Barone, MD | Newton, NJ | $43.3M | ✓ Clear |
| Jonathan Prenner, MD | New Brunswick, NJ | $43.1M | ✓ Clear |
| Sumit Shah, M.D. | New Brunswick, NJ | $37.0M | ✓ Clear |
| David Kim, M.D. | Union, NJ | $36.1M | ✓ Clear |
Share this provider's Medicare payment information
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.
Believe this data is inaccurate? Dispute this data