This provider averages 72 services per working day
Based on 179.0K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $32.3M 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 10893% from 2014 to 2023.
68% of their billing comes from a single procedure code (J0178 — Injection, aflibercept, 1 mg).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1880% 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 | $443.89 | $81.89 | 5.42x | $362.00 | $44.2K | 540 | 10 |
| 2015 | $372.26 | $166.89 | 2.23x | $205.37 | $875.5K | 5.2K | 24 |
| 2016 | $430.61 | $187.57 | 2.30x | $243.04 | $2.8M | 15.1K | 24 |
| 2017 | $451.23 | $192.15 | 2.35x | $259.08 | $3.3M | 17.0K | 22 |
| 2018 | $447.62 | $187.59 | 2.39x | $260.03 | $3.4M | 18.3K | 18 |
| 2019 | $476.83 | $201.07 | 2.37x | $275.76 | $3.7M | 18.2K | 22 |
| 2020 | $516.79 | $215.68 | 2.40x | $301.11 | $3.7M | 17.2K | 22 |
| 2021 | $501.98 | $208.92 | 2.40x | $293.06 | $4.3M | 20.7K | 22 |
| 2022 | $537.12 | $214.63 | 2.50x | $322.49 | $5.3M | 24.7K | 25 |
| 2023 | $311.05 | $115.70 | 2.69x | $195.35 | $4.9M | 42.0K | 20 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 29.5K | $21.6M | $733.56 | 2.31x |
| J2778 | Injection, ranibizumab, 0.1 mg | 11.0K | $2.8M | $253.61 | 2.76x |
| 67028 | Injection of drug into eye | 32.4K | $2.8M | $85.06 | 3.01x |
| J9035 | Injection, bevacizumab, 10 mg | 21.2K | $1.2M | $56.94 | 4.20x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 25.9K | $754.7K | $29.11 | 3.32x |
| 92134 | Imaging of retina | 24.6K | $714.2K | $28.98 | 1.45x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 5.8K | $322.0K | $55.46 | 1.50x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 1.2K | $301.9K | $248.69 | 2.35x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 2.0K | $224.5K | $114.29 | 1.44x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 2.3K | $174.7K | $77.17 | 1.42x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 637 | $173.4K | $272.15 | 1.71x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 203 | $158.7K | $781.56 | 1.68x |
| 67041 | Removal of membrane of retina | 176 | $125.2K | $711.35 | 1.64x |
| 67040 | Destruction of eye fluid (vitreous) between lens and retina and all of retina using a laser | 158 | $112.1K | $709.55 | 1.62x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 143 | $111.8K | $782.02 | 1.91x |
| 67113 | Complex repair of detached retina and drainage of eye fluid between lens and retina | 121 | $102.1K | $843.71 | 1.78x |
| 92250 | Photography of the retina | 2.5K | $91.3K | $36.21 | 1.48x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 185 | $86.8K | $469.33 | 2.05x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 1.0K | $83.6K | $83.34 | 1.45x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 874 | $75.7K | $86.57 | 1.42x |
This provider submits charges 2.44 times higher than what Medicare actually pays.
A markup ratio of 2.44x means for every $100 Medicare pays, this provider initially charges $244. 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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