This provider averages 92 services per working day
Based on 229.8K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $49.8M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 92 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 114% from 2014 to 2023.
65% of their billing comes from a single procedure code (J0178 — Injection, aflibercept, 1 mg).
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 | $601.87 | $172.95 | 3.48x | $428.92 | $3.5M | 20.5K | 16 |
| 2015 | $617.68 | $172.11 | 3.59x | $445.57 | $3.2M | 18.8K | 16 |
| 2016 | $636.74 | $174.05 | 3.66x | $462.69 | $3.5M | 20.1K | 15 |
| 2017 | $675.25 | $179.52 | 3.76x | $495.73 | $3.8M | 21.2K | 16 |
| 2018 | $760.77 | $204.12 | 3.73x | $556.65 | $4.3M | 21.3K | 15 |
| 2019 | $877.31 | $233.08 | 3.76x | $644.23 | $5.1M | 21.9K | 15 |
| 2020 | $965.91 | $255.50 | 3.78x | $710.41 | $5.2M | 20.5K | 14 |
| 2021 | $961.11 | $257.08 | 3.74x | $704.03 | $6.4M | 25.0K | 14 |
| 2022 | $1.0K | $260.72 | 3.88x | $751.53 | $7.0M | 26.8K | 11 |
| 2023 | $916.45 | $224.90 | 4.07x | $691.55 | $7.6M | 33.7K | 11 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 44.2K | $32.6M | $736.49 | 3.30x |
| J2778 | Injection, ranibizumab, 0.1 mg | 28.3K | $7.4M | $259.68 | 3.23x |
| 67028 | Injection of drug into eye | 33.0K | $3.3M | $100.64 | 9.77x |
| 92014 | Established patient complete exam of visual system | 26.8K | $2.6M | $98.31 | 3.92x |
| 92134 | Imaging of retina | 56.5K | $2.0M | $35.38 | 4.55x |
| J9035 | Injection, bevacizumab, 10 mg | 14.3K | $816.9K | $57.09 | 1.75x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 4.4K | $264.9K | $60.15 | 3.58x |
| 92235 | Imaging of blood vessels in back of eye using fluorescein dye | 974 | $140.9K | $144.68 | 3.80x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 4.8K | $139.3K | $29.02 | 3.45x |
| 92004 | New patient complete exam of visual system | 1.2K | $137.1K | $116.85 | 3.75x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 3.4K | $128.7K | $37.31 | 2.77x |
| 92012 | Established patient problem focused exam of visual system | 969 | $67.2K | $69.37 | 3.96x |
| 92250 | Photography of the retina | 837 | $45.6K | $54.45 | 3.95x |
| 67145 | Preventive retinal detachment treatment by heat or laser, 1 or more sessions | 100 | $40.8K | $408.08 | 4.00x |
| 92201 | Extended exam of the back part of the eye with retinal drawing | 1.6K | $33.3K | $21.23 | 4.48x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 847 | $32.4K | $38.23 | 2.93x |
| J3300 | Injection, triamcinolone acetonide, preservative free, 1 mg | 7.3K | $21.3K | $2.92 | 3.42x |
| 99204 | New patient outpatient visit, total time 45-59 minutes | 120 | $14.3K | $119.17 | 5.62x |
| 76512 | 2d ultrasound scan of eye tissue and structures | 199 | $13.8K | $69.30 | 5.12x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 14 | $11.3K | $804.66 | 3.23x |
This provider submits charges 3.78 times higher than what Medicare actually pays.
A markup ratio of 3.78x means for every $100 Medicare pays, this provider initially charges $378. 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 MA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| David Reed, M.D. | Plymouth, MA | $44.2M | ✓ Clear |
| Chirag Shah, MD | Boston, MA | $34.3M | ✓ 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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