This provider averages 172 services per working day
Based on 430.7K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $63.1M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 172 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 132% from 2014 to 2023.
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 | $351.92 | $159.56 | 2.21x | $192.36 | $4.1M | 25.5K | 22 |
| 2015 | $358.98 | $153.38 | 2.34x | $205.60 | $5.1M | 33.1K | 25 |
| 2016 | $335.31 | $136.86 | 2.45x | $198.45 | $4.8M | 35.3K | 27 |
| 2017 | $335.84 | $142.17 | 2.36x | $193.67 | $5.1M | 35.9K | 25 |
| 2018 | $351.30 | $147.89 | 2.38x | $203.41 | $5.9M | 40.0K | 27 |
| 2019 | $358.82 | $149.24 | 2.40x | $209.58 | $6.7M | 44.8K | 29 |
| 2020 | $435.01 | $175.31 | 2.48x | $259.70 | $7.0M | 39.9K | 31 |
| 2021 | $441.98 | $172.09 | 2.57x | $269.89 | $7.1M | 41.5K | 32 |
| 2022 | $414.63 | $154.97 | 2.68x | $259.66 | $7.8M | 50.1K | 31 |
| 2023 | $321.07 | $111.93 | 2.87x | $209.14 | $9.5M | 84.5K | 35 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2778 | Injection, ranibizumab, 0.1 mg | 100.2K | $27.7M | $276.36 | 1.81x |
| J0178 | Injection, aflibercept, 1 mg | 18.2K | $13.3M | $731.30 | 1.82x |
| 92014 | Established patient complete exam of visual system | 43.7K | $4.3M | $98.72 | 1.69x |
| 67028 | Injection of drug into eye | 34.1K | $3.4M | $99.23 | 9.31x |
| 92134 | Imaging of retina | 63.4K | $2.2M | $34.07 | 3.66x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 46.4K | $1.3M | $28.90 | 2.24x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 6.0K | $1.3M | $217.23 | 3.66x |
| J3490 | Unclassified drugs | 1.3K | $1.1M | $868.79 | 2.13x |
| Q5124 | Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg | 5.1K | $894.5K | $176.61 | 2.24x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 9.4K | $793.8K | $84.60 | 2.20x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 38.1K | $767.1K | $20.13 | 3.85x |
| 92012 | Established patient problem focused exam of visual system | 10.4K | $726.9K | $70.22 | 1.65x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 623 | $593.1K | $952.07 | 4.73x |
| J7999 | Compounded drug, not otherwise classified | 6.9K | $441.2K | $64.07 | 1.62x |
| 67039 | Destruction of eye fluid (vitreous) between lens and retina using a laser | 549 | $438.1K | $797.91 | 5.68x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 2.8K | $427.8K | $155.50 | 3.17x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 3.3K | $419.3K | $125.46 | 1.69x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 3.4K | $408.0K | $120.36 | 3.34x |
| 92250 | Photography of the retina | 6.9K | $336.8K | $48.52 | 1.96x |
| J3590 | Unclassified biologics | 909 | $283.8K | $312.26 | 1.83x |
This provider submits charges 2.51 times higher than what Medicare actually pays.
A markup ratio of 2.51x means for every $100 Medicare pays, this provider initially charges $251. 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 |
|---|---|---|---|
| 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 |
| Robert Wendel, M.D. | Sacramento, CA | $40.6M | ✓ 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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