This provider averages 72 services per working day
Based on 179.6K 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 72 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 482% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 138% in 2020
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 | $202.95 | $70.04 | 2.90x | $132.91 | $588.9K | 8.4K | 18 |
| 2015 | $213.19 | $70.35 | 3.03x | $142.84 | $617.4K | 8.8K | 17 |
| 2016 | $205.84 | $65.67 | 3.13x | $140.17 | $559.3K | 8.5K | 14 |
| 2017 | $205.02 | $62.50 | 3.28x | $142.52 | $570.6K | 9.1K | 19 |
| 2018 | $226.29 | $71.85 | 3.15x | $154.44 | $696.3K | 9.7K | 15 |
| 2019 | $218.83 | $69.66 | 3.14x | $149.17 | $636.0K | 9.1K | 15 |
| 2020 | $596.72 | $150.23 | 3.97x | $446.49 | $1.5M | 10.1K | 17 |
| 2021 | $804.59 | $188.75 | 4.26x | $615.84 | $2.4M | 12.6K | 17 |
| 2022 | $605.87 | $135.69 | 4.47x | $470.18 | $3.0M | 22.3K | 14 |
| 2023 | $187.65 | $42.38 | 4.43x | $145.27 | $3.4M | 80.9K | 14 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 4.9K | $3.5M | $722.42 | 4.10x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 80.8K | $2.3M | $29.05 | 4.00x |
| J2778 | Injection, ranibizumab, 0.1 mg | 9.6K | $2.2M | $226.81 | 5.45x |
| 67028 | Injection of drug into eye | 10.1K | $935.2K | $92.45 | 4.32x |
| 92134 | Imaging of retina | 24.5K | $824.8K | $33.67 | 3.30x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 8.4K | $680.0K | $80.75 | 3.09x |
| 92014 | Established patient complete exam of visual system | 6.5K | $612.3K | $94.45 | 3.60x |
| 92012 | Established patient problem focused exam of visual system | 7.4K | $513.4K | $69.41 | 3.01x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 4.6K | $424.2K | $92.47 | 3.41x |
| 67041 | Removal of membrane from the retina | 373 | $376.6K | $1.0K | 2.96x |
| 67113 | Complex repair of detached retina and drainage of eye fluid between lens and retina | 259 | $286.7K | $1.1K | 3.08x |
| J7999 | Compounded drug, not otherwise classified | 4.1K | $260.8K | $63.82 | 2.73x |
| 92250 | Photography of the retina | 5.1K | $220.7K | $43.31 | 4.26x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 187 | $184.1K | $984.58 | 3.50x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 133 | $130.4K | $980.82 | 3.94x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.0K | $122.2K | $118.53 | 3.94x |
| 67040 | Laser destruction of eye fluid (vitreous) between the lens and retina, all of the retina | 98 | $87.6K | $893.40 | 3.41x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 548 | $58.7K | $107.20 | 3.35x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 343 | $54.6K | $159.28 | 2.90x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 70 | $50.2K | $716.69 | 3.83x |
This provider submits charges 4.01 times higher than what Medicare actually pays.
A markup ratio of 4.01x means for every $100 Medicare pays, this provider initially charges $401. This is higher 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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