This provider's $3.9M in total Medicare payments ranks in the 95th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 1259% from 2016 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 269% in 2017
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 |
|---|---|---|---|---|---|---|---|
| 2016 | $200.30 | $70.04 | 2.86x | $130.26 | $51.0K | 780 | 619 |
| 2017 | $376.55 | $92.02 | 4.09x | $284.53 | $188.2K | 2.9K | 1.8K |
| 2018 | $404.76 | $111.03 | 3.65x | $293.73 | $261.5K | 3.9K | 2.4K |
| 2019 | $442.32 | $136.48 | 3.24x | $305.84 | $386.3K | 4.7K | 2.8K |
| 2020 | $590.57 | $170.44 | 3.46x | $420.13 | $547.3K | 4.7K | 2.3K |
| 2021 | $656.83 | $190.59 | 3.45x | $466.24 | $816.0K | 5.6K | 2.9K |
| 2022 | $558.99 | $215.80 | 2.59x | $343.19 | $972.3K | 6.6K | 3.4K |
| 2023 | $649.82 | $160.15 | 4.06x | $489.67 | $693.2K | 6.9K | 3.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 1.8K | $1.3M | $725.35 | 1.46x |
| 67028 | Injection of drug into eye | 5.9K | $527.1K | $88.80 | 7.66x |
| 66984 | Removal of cataract with insertion of lens | 679 | $296.6K | $436.77 | 4.58x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 3.0K | $268.9K | $88.34 | 2.12x |
| 92134 | Diagnostic imaging of retina | 8.1K | $249.9K | $30.90 | 4.86x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 1.7K | $185.8K | $107.17 | 2.33x |
| J9035 | Injection, bevacizumab, 10 mg | 2.5K | $144.6K | $58.64 | 1.71x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.6K | $143.4K | $54.71 | 2.11x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 2.2K | $143.4K | $65.80 | 1.92x |
| J2778 | Injection, ranibizumab, 0.1 mg | 480 | $126.3K | $263.15 | 1.63x |
| J3590 | Unclassified biologics | 69 | $122.3K | $1.8K | 1.50x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 630 | $74.5K | $118.32 | 2.14x |
| 67145 | Preventive retinal detachment treatment by heat or laser, 1 or more sessions | 163 | $61.3K | $376.25 | 4.19x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 155 | $42.8K | $275.88 | 3.41x |
| 92250 | Photography of the retina | 1.5K | $42.7K | $29.28 | 4.78x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 471 | $39.8K | $84.52 | 2.22x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 99 | $27.0K | $272.81 | 8.89x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 1.2K | $24.4K | $19.50 | 3.13x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 794 | $23.2K | $29.18 | 1.50x |
| 92136 | Measurement of corneal curvature and depth of eye | 671 | $22.2K | $33.16 | 5.43x |
This provider submits charges 3.12 times higher than what Medicare actually pays.
A markup ratio of 3.12x means for every $100 Medicare pays, this provider initially charges $312. 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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