This provider averages 53 services per working day
Based on 132.4K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $20.3M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 53 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 178% from 2014 to 2023.
69% 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 | $171.82 | $122.74 | 1.40x | $49.08 | $1.2M | 10.0K | 16 |
| 2015 | $168.02 | $120.83 | 1.39x | $47.19 | $1.3M | 10.7K | 14 |
| 2016 | $197.96 | $139.39 | 1.42x | $58.57 | $1.5M | 10.7K | 14 |
| 2017 | $234.06 | $153.00 | 1.53x | $81.06 | $1.6M | 10.3K | 13 |
| 2018 | $248.08 | $161.07 | 1.54x | $87.01 | $1.8M | 11.0K | 14 |
| 2019 | $447.86 | $180.21 | 2.49x | $267.65 | $1.8M | 10.0K | 11 |
| 2020 | $600.23 | $206.17 | 2.91x | $394.06 | $2.2M | 10.5K | 12 |
| 2021 | $1.1K | $218.69 | 5.25x | $929.75 | $2.5M | 11.6K | 13 |
| 2022 | $1.0K | $194.67 | 5.23x | $823.94 | $3.1M | 15.8K | 13 |
| 2023 | $497.13 | $106.35 | 4.67x | $390.78 | $3.4M | 31.9K | 10 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 19.1K | $14.0M | $734.09 | 3.38x |
| 67028 | Injection of drug into eye | 21.7K | $1.8M | $84.54 | 3.77x |
| 92134 | Imaging of retina | 30.3K | $896.8K | $29.59 | 3.17x |
| J3590 | Unclassified biologics | 15.0K | $849.5K | $56.49 | 4.31x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 21.7K | $628.1K | $29.00 | 1.38x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 11.0K | $572.7K | $52.29 | 3.07x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 5.9K | $429.6K | $72.98 | 1.90x |
| J2778 | Injection, ranibizumab, 0.1 mg | 989 | $305.0K | $308.42 | 1.28x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 910 | $138.3K | $152.01 | 1.82x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 1.7K | $125.4K | $73.57 | 2.28x |
| J3490 | Unclassified drugs | 54 | $98.8K | $1.8K | 3.90x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 859 | $97.9K | $113.99 | 2.69x |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 909 | $65.2K | $71.69 | 3.15x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 258 | $64.3K | $249.29 | 2.61x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 155 | $60.2K | $388.50 | 2.56x |
| 92250 | Photography of the retina | 1.1K | $46.7K | $43.72 | 1.96x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 184 | $26.2K | $142.47 | 1.43x |
| 92014 | Established patient complete exam of visual system | 317 | $24.1K | $76.06 | 6.40x |
| 99215 | Established patient outpatient visit, total time 40-54 minutes | 188 | $18.4K | $97.64 | 1.79x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 13 | $5.3K | $410.09 | 1.29x |
This provider submits charges 3.29 times higher than what Medicare actually pays.
A markup ratio of 3.29x means for every $100 Medicare pays, this provider initially charges $329. 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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