This provider averages 52 services per working day
Based on 130.5K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $16.4M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 52 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 | $629.73 | $296.69 | 2.12x | $333.04 | $1.5M | 14.1K | 5.3K |
| 2015 | $581.35 | $249.24 | 2.33x | $332.11 | $1.6M | 14.4K | 5.4K |
| 2016 | $807.54 | $279.96 | 2.88x | $527.58 | $1.8M | 14.5K | 5.3K |
| 2017 | $747.43 | $244.51 | 3.06x | $502.92 | $1.8M | 14.3K | 5.5K |
| 2018 | $689.76 | $244.38 | 2.82x | $445.38 | $1.6M | 13.6K | 5.2K |
| 2019 | $931.77 | $293.21 | 3.18x | $638.56 | $1.6M | 13.3K | 5.2K |
| 2020 | $613.07 | $212.86 | 2.88x | $400.21 | $1.6M | 12.2K | 4.3K |
| 2021 | $843.41 | $286.51 | 2.94x | $556.90 | $1.6M | 11.4K | 3.7K |
| 2022 | $910.22 | $267.10 | 3.41x | $643.12 | $1.7M | 11.3K | 4.1K |
| 2023 | $735.85 | $278.51 | 2.64x | $457.34 | $1.7M | 11.4K | 3.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 9.4K | $6.9M | $737.23 | 1.52x |
| 67028 | Injection of drug into eye | 25.0K | $2.4M | $96.38 | 7.29x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 15.8K | $1.1M | $70.98 | 2.07x |
| 92134 | Diagnostic imaging of retina | 27.0K | $938.1K | $34.75 | 2.32x |
| J7999 | Compounded drug, not otherwise classified | 11.5K | $856.8K | $74.35 | 2.00x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 9.1K | $756.6K | $83.15 | 2.12x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 5.5K | $564.0K | $101.94 | 1.74x |
| J2778 | Injection, ranibizumab, 0.1 mg | 1.7K | $478.4K | $282.56 | 1.77x |
| 92250 | Photography of the retina | 9.1K | $463.7K | $51.10 | 1.98x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.3K | $290.8K | $124.59 | 1.73x |
| 67042 | Removal of membrane from the retina, pars plana approach | 278 | $284.7K | $1.0K | 3.09x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.9K | $195.6K | $67.31 | 1.79x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 164 | $190.4K | $1.2K | 3.24x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.6K | $150.1K | $92.00 | 1.84x |
| J3590 | Unclassified biologics | 2.9K | $146.5K | $51.34 | 1.95x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 733 | $113.1K | $154.35 | 1.68x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 179 | $92.3K | $515.84 | 4.12x |
| 67040 | Laser destruction of eye fluid (vitreous) between the lens and retina | 103 | $79.6K | $772.83 | 4.01x |
| 76512 | Ultrasound of eye disease, growth, or structure | 1.1K | $69.5K | $60.42 | 2.96x |
| Q9977 | Compounded Drug, Not Otherwise Classified | 759 | $44.2K | $58.18 | 1.72x |
This provider submits charges 2.65 times higher than what Medicare actually pays.
A markup ratio of 2.65x means for every $100 Medicare pays, this provider initially charges $265. 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 CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Nathan Steinle, M.D. | Santa Barbara, CA | $63.1M | ✓ Clear |
| Stephen Couvillion, MD | Santa Barbara, CA | $47.7M | ✓ Clear |
| Margaret Chang, M.D. | Sacramento, CA | $47.6M | ✓ Clear |
| David Boyer, MD | Los Angeles, CA | $47.5M | ✓ Clear |
| Alessandro Castellarin, M.D. | Santa Barbara, CA | $46.9M | ✓ 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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