This provider averages 106 services per working day
Based on 264.3K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $35.2M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 106 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 | $220.72 | $104.27 | 2.12x | $116.45 | $3.1M | 30.0K | 28 |
| 2015 | $269.87 | $102.64 | 2.63x | $167.23 | $3.4M | 32.8K | 30 |
| 2016 | $216.46 | $94.05 | 2.30x | $122.41 | $3.0M | 31.7K | 32 |
| 2017 | $235.80 | $103.15 | 2.29x | $132.65 | $2.9M | 27.7K | 30 |
| 2018 | $276.79 | $129.60 | 2.14x | $147.19 | $3.3M | 25.8K | 25 |
| 2019 | $303.82 | $150.31 | 2.02x | $153.51 | $3.8M | 25.0K | 27 |
| 2020 | $360.19 | $181.05 | 1.99x | $179.14 | $3.8M | 20.8K | 26 |
| 2021 | $419.70 | $188.42 | 2.23x | $231.28 | $4.1M | 21.7K | 24 |
| 2022 | $472.32 | $191.50 | 2.47x | $280.82 | $3.9M | 20.3K | 27 |
| 2023 | $344.52 | $139.85 | 2.46x | $204.67 | $4.0M | 28.5K | 24 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 20.7K | $15.0M | $725.82 | 1.76x |
| J2778 | Injection, ranibizumab, 0.1 mg | 25.9K | $7.5M | $288.85 | 1.77x |
| 67028 | Injection of drug into eye | 30.2K | $2.4M | $78.48 | 4.53x |
| 92134 | Imaging of retina | 66.5K | $1.9M | $28.89 | 2.73x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 28.0K | $1.4M | $48.45 | 1.97x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 16.0K | $1.2M | $77.66 | 2.01x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 9.3K | $764.8K | $82.65 | 1.82x |
| J3590 | Unclassified biologics | 15.0K | $696.2K | $46.52 | 2.01x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 1.2K | $424.0K | $349.23 | 6.56x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 13.8K | $396.5K | $28.73 | 1.57x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 4.8K | $372.8K | $78.40 | 2.64x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 6.5K | $363.3K | $55.76 | 1.79x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 3.1K | $337.1K | $107.87 | 1.98x |
| 67210 | Destruction of growth of retina using a laser | 796 | $299.6K | $376.37 | 5.07x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 403 | $252.9K | $627.61 | 6.73x |
| J3490 | Unclassified drugs | 165 | $235.6K | $1.4K | 1.40x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 233 | $215.7K | $925.61 | 5.70x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 231 | $203.8K | $882.27 | 5.46x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 1.2K | $196.1K | $158.24 | 1.71x |
| 67041 | Removal of membrane of retina | 212 | $184.7K | $871.27 | 5.53x |
This provider submits charges 2.26 times higher than what Medicare actually pays.
A markup ratio of 2.26x means for every $100 Medicare pays, this provider initially charges $226. 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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