⚠️ This provider averages 224 services per working day — physically unusual for an individual practitioner
Based on 560.5K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $99.5M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 224 services per working day raises questions about billing patterns.
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 | $525.78 | $169.36 | 3.10x | $356.42 | $10.2M | 60.3K | 37 |
| 2015 | $520.72 | $168.10 | 3.10x | $352.62 | $10.2M | 60.5K | 38 |
| 2016 | $582.04 | $188.06 | 3.09x | $393.98 | $9.5M | 50.8K | 38 |
| 2017 | $604.41 | $199.85 | 3.02x | $404.56 | $9.2M | 46.2K | 32 |
| 2018 | $605.23 | $202.51 | 2.99x | $402.72 | $9.8M | 48.5K | 30 |
| 2019 | $609.60 | $199.24 | 3.06x | $410.36 | $11.0M | 55.4K | 24 |
| 2020 | $644.28 | $204.98 | 3.14x | $439.30 | $11.1M | 54.4K | 23 |
| 2021 | $614.68 | $201.21 | 3.05x | $413.47 | $9.7M | 48.3K | 21 |
| 2022 | $518.95 | $182.97 | 2.84x | $335.98 | $8.9M | 48.7K | 23 |
| 2023 | $367.49 | $110.86 | 3.31x | $256.63 | $9.7M | 87.5K | 22 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2778 | Injection, ranibizumab, 0.1 mg | 174.5K | $48.2M | $276.13 | 2.83x |
| J0178 | Injection, aflibercept, 1 mg | 34.7K | $25.5M | $734.76 | 2.58x |
| 67028 | Injection of drug into eye | 55.6K | $5.0M | $89.62 | 4.42x |
| 92014 | Established patient complete exam of visual system | 41.1K | $3.8M | $92.58 | 3.76x |
| 92250 | Photography of the retina | 63.7K | $2.9M | $44.87 | 4.48x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 31.9K | $2.6M | $82.62 | 4.83x |
| J3490 | Unclassified drugs | 3.0K | $2.2M | $733.85 | 4.51x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 49.2K | $1.4M | $29.07 | 2.61x |
| 92134 | Imaging of retina | 41.6K | $1.4M | $32.84 | 3.70x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 8.3K | $1.3M | $156.14 | 2.52x |
| J7313 | Injection, fluocinolone acetonide, intravitreal implant, 0.01 mg | 2.2K | $615.8K | $280.82 | 1.64x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 5.0K | $602.9K | $121.80 | 4.00x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 2.8K | $593.9K | $214.24 | 2.54x |
| 67210 | Destruction of growth of retina using a laser | 1.1K | $481.9K | $434.10 | 4.89x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 608 | $389.6K | $640.74 | 5.80x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 14.3K | $281.7K | $19.76 | 3.59x |
| J7314 | Injection, fluocinolone acetonide, intravitreal implant (yutiq), 0.01 mg | 613 | $250.9K | $409.22 | 1.63x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.0K | $246.0K | $82.04 | 3.96x |
| 67042 | Removal of membrane from the retina, pars plana approach | 202 | $208.6K | $1.0K | 4.67x |
| 92012 | Established patient problem focused exam of visual system | 2.9K | $193.9K | $65.80 | 3.63x |
This provider submits charges 3.07 times higher than what Medicare actually pays.
A markup ratio of 3.07x means for every $100 Medicare pays, this provider initially charges $307. 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 FL for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Sunil Gupta, M.D. | Pensacola, FL | $86.1M | ✓ Clear |
| Hussein Wafapoor, M.D. | Fort Myers, FL | $70.9M | ✓ Clear |
| John Myers, M.D. | Pensacola, FL | $69.4M | ✓ Clear |
| Thomas Baudo, M.D. | Vero Beach, FL | $64.2M | ✓ Clear |
| Keye Wong, M.D. | Sarasota, FL | $55.2M | ✓ 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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