This provider's $11.3M in total Medicare payments ranks in the 98th percentile of Ophthalmology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $351.47 | $231.09 | 1.52x | $120.38 | $918.8K | 10.0K | 3.8K |
| 2015 | $412.93 | $258.02 | 1.60x | $154.91 | $1.0M | 10.2K | 3.8K |
| 2016 | $545.65 | $301.10 | 1.81x | $244.55 | $1.1M | 10.8K | 3.9K |
| 2017 | $386.27 | $256.56 | 1.51x | $129.71 | $1.1M | 11.4K | 4.1K |
| 2018 | $309.76 | $214.84 | 1.44x | $94.92 | $1.2M | 13.6K | 4.8K |
| 2019 | $456.83 | $304.63 | 1.50x | $152.20 | $1.3M | 14.5K | 5.1K |
| 2020 | $343.97 | $201.21 | 1.71x | $142.76 | $1.2M | 13.0K | 4.6K |
| 2021 | $328.46 | $181.89 | 1.81x | $146.57 | $1.2M | 13.1K | 4.4K |
| 2022 | $409.13 | $192.34 | 2.13x | $216.79 | $1.1M | 12.4K | 4.3K |
| 2023 | $468.47 | $187.17 | 2.50x | $281.30 | $1.1M | 12.1K | 4.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 32.5K | $2.9M | $90.07 | 1.91x |
| J0178 | Injection, aflibercept, 1 mg | 2.8K | $2.1M | $742.70 | 1.42x |
| 67028 | Injection of drug into eye | 23.4K | $1.9M | $82.15 | 1.84x |
| J7999 | Compounded drug, not otherwise classified | 15.4K | $1.0M | $65.49 | 1.44x |
| 92250 | Photography of the retina | 15.1K | $625.4K | $41.55 | 2.02x |
| 92134 | Diagnostic imaging of retina | 19.1K | $610.2K | $32.03 | 1.84x |
| 67042 | Removal of membrane from the retina, pars plana approach | 468 | $436.1K | $931.80 | 1.73x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 1.1K | $432.5K | $404.58 | 1.73x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 2.5K | $202.0K | $80.54 | 1.78x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 423 | $144.9K | $342.46 | 2.00x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 836 | $131.0K | $156.68 | 1.35x |
| J3590 | Unclassified biologics | 1.7K | $127.4K | $73.78 | 1.46x |
| 92242 | Imaging of blood vessels in back of eye using fluorescein and indocyanine-green dye | 657 | $124.7K | $189.87 | 1.73x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 165 | $111.6K | $676.34 | 1.78x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 1.0K | $69.4K | $66.63 | 1.57x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 40 | $43.0K | $1.1K | 1.56x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 41 | $42.4K | $1.0K | 1.62x |
| J2778 | Injection, ranibizumab, 0.1 mg | 115 | $35.5K | $308.43 | 1.60x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 314 | $33.1K | $105.28 | 1.94x |
| 92240 | Examination of eye using an endoscope | 177 | $32.1K | $181.40 | 1.53x |
This provider submits charges 1.73 times higher than what Medicare actually pays.
A markup ratio of 1.73x means for every $100 Medicare pays, this provider initially charges $173. This is lower 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 WA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Charles Sung, MD | Kennewick, WA | $38.3M | ✓ Clear |
| David Spinak, MD | Silverdale, WA | $34.8M | ✓ 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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