⚠️ This provider averages 229 services per working day — physically unusual for an individual practitioner
Based on 572.7K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $37.3M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 229 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 | $183.24 | $135.73 | 1.35x | $47.51 | $4.0M | 29.8K | 23 |
| 2015 | $177.63 | $131.06 | 1.36x | $46.57 | $3.8M | 29.3K | 25 |
| 2016 | $183.62 | $132.02 | 1.39x | $51.60 | $3.7M | 28.0K | 28 |
| 2017 | $209.14 | $144.44 | 1.45x | $64.70 | $3.3M | 23.1K | 28 |
| 2018 | $206.34 | $140.64 | 1.47x | $65.70 | $3.8M | 27.0K | 29 |
| 2019 | $202.68 | $135.11 | 1.50x | $67.57 | $3.7M | 27.2K | 26 |
| 2020 | $536.79 | $158.46 | 3.39x | $378.33 | $3.4M | 21.3K | 23 |
| 2021 | $570.63 | $166.83 | 3.42x | $403.80 | $3.5M | 21.2K | 22 |
| 2022 | $436.34 | $120.07 | 3.63x | $316.27 | $3.6M | 30.3K | 24 |
| 2023 | $49.87 | $12.92 | 3.86x | $36.95 | $4.3M | 335.5K | 26 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 19.8K | $14.8M | $746.00 | 2.17x |
| J2778 | Injection, ranibizumab, 0.1 mg | 29.4K | $8.3M | $282.28 | 2.02x |
| 67028 | Injection of drug into eye | 26.8K | $2.2M | $82.89 | 2.30x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 57.8K | $1.7M | $29.23 | 3.98x |
| 92014 | Established patient complete exam of visual system | 18.1K | $1.5M | $82.72 | 2.19x |
| 92134 | Imaging of retina | 49.4K | $1.5M | $29.62 | 2.13x |
| 92012 | Established patient problem focused exam of visual system | 20.7K | $1.2M | $59.42 | 2.02x |
| J3490 | Unclassified drugs | 9.3K | $676.7K | $72.51 | 3.75x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 4.1K | $631.4K | $155.78 | 1.90x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 21.3K | $546.2K | $25.65 | 1.36x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 577 | $533.4K | $924.41 | 1.81x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 5.2K | $443.7K | $85.60 | 2.62x |
| J3590 | Unclassified biologics | 231 | $410.1K | $1.8K | 4.10x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 2.9K | $329.7K | $113.84 | 2.63x |
| 92250 | Photography of the retina | 9.8K | $323.6K | $33.14 | 3.23x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 3.7K | $323.5K | $86.70 | 1.47x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 3.8K | $233.5K | $62.21 | 2.41x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 323 | $212.3K | $657.25 | 2.13x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 1.7K | $205.8K | $120.36 | 4.00x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 768 | $165.2K | $215.12 | 3.39x |
This provider submits charges 2.29 times higher than what Medicare actually pays.
A markup ratio of 2.29x means for every $100 Medicare pays, this provider initially charges $229. 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 FL for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Alexander Eaton, MD | Fort Myers, FL | $99.5M | ✓ Clear |
| Sunil Gupta, M.D. | Pensacola, FL | $86.1M | ✓ Clear |
| Hussein Wafapoor, M.D. | Fort Myers, FL | $70.9M | ✓ Clear |
| John Myers, M.D. | Pensacola, FL | $69.4M | ✓ Clear |
| Thomas Baudo, M.D. | Vero Beach, FL | $64.2M | ✓ 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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