This provider averages 90 services per working day
Based on 226.1K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $21.6M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 90 services per working day raises questions about billing patterns.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 80% in 2021
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 | $1.1K | $319.81 | 3.36x | $755.09 | $3.4M | 35.9K | 16.0K |
| 2015 | $738.07 | $268.42 | 2.75x | $469.65 | $2.7M | 31.9K | 14.5K |
| 2016 | $707.85 | $238.22 | 2.97x | $469.63 | $2.6M | 33.0K | 14.2K |
| 2017 | $803.41 | $249.14 | 3.22x | $554.27 | $2.1M | 29.5K | 12.9K |
| 2018 | $605.63 | $187.71 | 3.23x | $417.92 | $1.6M | 17.7K | 9.3K |
| 2019 | $619.33 | $195.44 | 3.17x | $423.89 | $1.2M | 12.8K | 7.1K |
| 2020 | $649.08 | $217.90 | 2.98x | $431.18 | $1.4M | 12.8K | 6.6K |
| 2021 | $487.35 | $188.73 | 2.58x | $298.62 | $2.6M | 20.4K | 8.2K |
| 2022 | $550.77 | $185.41 | 2.97x | $365.36 | $2.5M | 20.0K | 8.1K |
| 2023 | $548.90 | $203.99 | 2.69x | $344.91 | $1.4M | 11.9K | 5.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 6.2K | $4.6M | $737.92 | 1.73x |
| 67028 | Injection of drug into eye | 29.3K | $2.6M | $89.70 | 4.10x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 25.2K | $2.6M | $101.53 | 3.79x |
| 92134 | Diagnostic imaging of retina | 54.4K | $1.9M | $35.58 | 2.84x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 16.0K | $1.4M | $85.47 | 2.93x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 15.6K | $1.1M | $72.08 | 2.65x |
| 92242 | Imaging of blood vessels in back of eye using fluorescein and indocyanine-green dye | 4.2K | $954.3K | $226.18 | 2.33x |
| 92250 | Photography of the retina | 15.7K | $807.0K | $51.43 | 3.50x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 1.2K | $641.0K | $516.52 | 4.39x |
| J2778 | Injection, ranibizumab, 0.1 mg | 2.3K | $596.0K | $255.34 | 2.05x |
| J9035 | Injection, bevacizumab, 10 mg | 11.0K | $591.4K | $53.71 | 1.43x |
| J7999 | Compounded drug, not otherwise classified | 9.1K | $544.0K | $59.66 | 1.32x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.8K | $351.8K | $127.79 | 2.83x |
| 92083 | Measurement of field of vision during daylight conditions | 6.6K | $342.1K | $51.75 | 2.83x |
| 67042 | Removal of membrane from the retina, pars plana approach | 275 | $290.9K | $1.1K | 2.90x |
| 67105 | Repair of detached retina, 1 or more sessions | 615 | $286.9K | $466.47 | 3.48x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 206 | $264.5K | $1.3K | 3.22x |
| 92133 | Diagnostic imaging of optic nerve of eye | 7.1K | $207.8K | $29.37 | 3.36x |
| 67220 | Destruction of vascular growth between retina and sclera, 1 or more sessions | 393 | $183.1K | $465.78 | 2.68x |
| 76512 | Ultrasound of eye disease, growth, or structure | 2.7K | $168.3K | $61.98 | 3.39x |
This provider submits charges 2.84 times higher than what Medicare actually pays.
A markup ratio of 2.84x means for every $100 Medicare pays, this provider initially charges $284. This is higher 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 CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Nathan Steinle, M.D. | Santa Barbara, CA | $63.1M | ✓ Clear |
| Stephen Couvillion, MD | Santa Barbara, CA | $47.7M | ✓ Clear |
| Margaret Chang, M.D. | Sacramento, CA | $47.6M | ✓ Clear |
| David Boyer, MD | Los Angeles, CA | $47.5M | ✓ Clear |
| Alessandro Castellarin, M.D. | Santa Barbara, CA | $46.9M | ✓ 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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