This provider averages 75 services per working day
Based on 187.4K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $35.7M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 75 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 56% from 2014 to 2023.
67% 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 | $343.72 | $223.01 | 1.54x | $120.71 | $2.8M | 12.4K | 20 |
| 2015 | $333.48 | $252.69 | 1.32x | $80.79 | $3.3M | 12.9K | 22 |
| 2016 | $318.19 | $227.64 | 1.40x | $90.55 | $3.0M | 13.1K | 21 |
| 2017 | $352.00 | $241.53 | 1.46x | $110.47 | $3.0M | 12.5K | 22 |
| 2018 | $341.38 | $262.53 | 1.30x | $78.85 | $3.6M | 13.6K | 22 |
| 2019 | $365.20 | $278.44 | 1.31x | $86.76 | $4.1M | 14.7K | 19 |
| 2020 | $429.60 | $298.86 | 1.44x | $130.74 | $3.6M | 12.0K | 22 |
| 2021 | $428.49 | $319.79 | 1.34x | $108.70 | $4.1M | 12.8K | 23 |
| 2022 | $284.28 | $197.33 | 1.44x | $86.95 | $4.0M | 20.5K | 23 |
| 2023 | $95.11 | $68.43 | 1.39x | $26.68 | $4.3M | 62.9K | 22 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 32.1K | $23.8M | $742.04 | 1.31x |
| J2778 | Injection, ranibizumab, 0.1 mg | 15.8K | $4.5M | $281.99 | 1.35x |
| 67028 | Injection of drug into eye | 21.2K | $2.0M | $93.42 | 1.99x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 60.8K | $1.8M | $29.22 | 1.35x |
| 92134 | Imaging of retina | 30.3K | $1.0M | $33.44 | 1.52x |
| 92012 | Established patient problem focused exam of visual system | 10.2K | $663.5K | $65.30 | 1.51x |
| J3590 | Unclassified biologics | 1.0K | $346.8K | $331.84 | 2.42x |
| J7999 | Compounded drug, not otherwise classified | 3.3K | $208.8K | $62.44 | 2.14x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 171 | $164.3K | $961.10 | 1.43x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 264 | $121.6K | $460.72 | 1.46x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 107 | $110.6K | $1.0K | 1.43x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 1.3K | $109.0K | $85.88 | 1.49x |
| 92014 | Established patient complete exam of visual system | 887 | $93.0K | $104.89 | 1.44x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 210 | $87.2K | $415.06 | 1.55x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 562 | $85.0K | $151.33 | 1.56x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 673 | $82.0K | $121.78 | 1.53x |
| 67210 | Destruction of growth of retina using a laser | 164 | $72.2K | $440.41 | 1.47x |
| 92004 | New patient complete exam of visual system | 465 | $54.0K | $116.03 | 1.46x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 66 | $51.1K | $774.53 | 1.35x |
| 92250 | Photography of the retina | 1.1K | $49.0K | $45.65 | 1.41x |
This provider submits charges 1.39 times higher than what Medicare actually pays.
A markup ratio of 1.39x means for every $100 Medicare pays, this provider initially charges $139. This is lower 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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