This provider averages 64 services per working day
Based on 159.5K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $26.7M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 64 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 723% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 335% 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 | $675.41 | $231.05 | 2.92x | $444.36 | $468.8K | 2.0K | 10 |
| 2015 | $831.48 | $275.94 | 3.01x | $555.54 | $2.0M | 7.4K | 12 |
| 2016 | $707.77 | $258.50 | 2.74x | $449.27 | $1.9M | 7.5K | 19 |
| 2017 | $392.38 | $230.90 | 1.70x | $161.48 | $2.2M | 9.7K | 22 |
| 2018 | $401.48 | $243.22 | 1.65x | $158.26 | $3.1M | 12.7K | 23 |
| 2019 | $428.64 | $249.42 | 1.72x | $179.22 | $3.1M | 12.4K | 17 |
| 2020 | $463.40 | $260.42 | 1.78x | $202.98 | $3.2M | 12.2K | 18 |
| 2021 | $488.73 | $265.27 | 1.84x | $223.46 | $3.3M | 12.5K | 20 |
| 2022 | $270.20 | $152.96 | 1.77x | $117.24 | $3.5M | 22.9K | 20 |
| 2023 | $107.32 | $64.09 | 1.67x | $43.23 | $3.9M | 60.2K | 21 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 16.6K | $12.3M | $738.48 | 1.86x |
| J2778 | Injection, ranibizumab, 0.1 mg | 30.0K | $8.0M | $266.79 | 2.01x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 60.8K | $1.8M | $29.12 | 1.37x |
| 67028 | Injection of drug into eye | 14.2K | $1.4M | $96.93 | 2.78x |
| 92134 | Imaging of retina | 20.2K | $663.1K | $32.85 | 2.34x |
| J3590 | Unclassified biologics | 654 | $514.6K | $786.82 | 1.48x |
| 92014 | Established patient complete exam of visual system | 3.7K | $338.8K | $90.67 | 1.95x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 2.0K | $315.6K | $157.64 | 2.38x |
| J3490 | Unclassified drugs | 152 | $266.4K | $1.8K | 1.41x |
| 92004 | New patient complete exam of visual system | 1.7K | $185.1K | $110.99 | 1.93x |
| 92012 | Established patient problem focused exam of visual system | 2.4K | $165.1K | $68.58 | 1.68x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 113 | $103.8K | $918.20 | 1.67x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 373 | $92.7K | $248.66 | 1.41x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 994 | $86.1K | $86.61 | 2.30x |
| 67031 | Release of scar tissue between lens and retina using a laser | 269 | $79.2K | $294.26 | 1.76x |
| 66821 | Removal of recurring cataract in lens capsule using a laser | 271 | $71.6K | $264.24 | 1.67x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 555 | $66.8K | $120.36 | 1.33x |
| J9035 | Injection, bevacizumab, 10 mg | 1.1K | $62.5K | $56.70 | 2.41x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 79 | $56.4K | $713.33 | 1.65x |
| 92250 | Photography of the retina | 960 | $44.6K | $46.45 | 2.21x |
This provider submits charges 1.93 times higher than what Medicare actually pays.
A markup ratio of 1.93x means for every $100 Medicare pays, this provider initially charges $193. This is lower than the national average.
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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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