This provider averages 75 services per working day
Based on 187.3K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $27.7M 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 118% 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 | $210.41 | $124.39 | 1.69x | $86.02 | $1.9M | 15.4K | 16 |
| 2015 | $213.22 | $124.46 | 1.71x | $88.76 | $2.0M | 16.4K | 18 |
| 2016 | $196.96 | $113.73 | 1.73x | $83.23 | $1.8M | 16.2K | 16 |
| 2017 | $197.79 | $114.09 | 1.73x | $83.70 | $1.9M | 16.7K | 16 |
| 2018 | $220.08 | $128.36 | 1.71x | $91.72 | $2.5M | 19.1K | 16 |
| 2019 | $238.61 | $140.20 | 1.70x | $98.41 | $2.9M | 20.8K | 14 |
| 2020 | $354.81 | $193.78 | 1.83x | $161.03 | $3.3M | 16.9K | 16 |
| 2021 | $463.56 | $191.36 | 2.42x | $272.20 | $3.4M | 18.0K | 13 |
| 2022 | $613.83 | $184.79 | 3.32x | $429.04 | $3.8M | 20.4K | 14 |
| 2023 | $658.35 | $152.83 | 4.31x | $505.52 | $4.2M | 27.3K | 15 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 19.7K | $14.4M | $732.88 | 2.01x |
| J2778 | Injection, ranibizumab, 0.1 mg | 15.9K | $4.1M | $257.40 | 2.43x |
| 92014 | Established patient complete exam of visual system | 31.2K | $3.3M | $104.84 | 1.88x |
| 67028 | Injection of drug into eye | 14.5K | $1.5M | $101.36 | 5.21x |
| 92134 | Imaging of retina | 33.0K | $1.2M | $37.18 | 4.62x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 31.4K | $702.0K | $22.39 | 2.11x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 4.3K | $424.4K | $99.07 | 2.00x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 2.2K | $292.7K | $132.45 | 1.93x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 3.1K | $282.5K | $90.07 | 2.41x |
| J3590 | Unclassified biologics | 104 | $256.5K | $2.5K | 3.07x |
| 92250 | Photography of the retina | 3.9K | $230.0K | $58.33 | 2.09x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 7.3K | $195.5K | $26.92 | 4.64x |
| 92202 | Extended exam of the back part of the eye with optic nerve drawing | 10.9K | $151.7K | $13.95 | 5.91x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 647 | $139.3K | $215.32 | 4.63x |
| J9035 | Injection, bevacizumab, 10 mg | 2.3K | $135.3K | $58.88 | 1.66x |
| J3490 | Unclassified drugs | 59 | $105.9K | $1.8K | 3.14x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 98 | $76.5K | $780.60 | 3.21x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 2.9K | $70.4K | $24.21 | 2.18x |
| 92201 | Extended exam of the back part of the eye with retinal drawing | 2.7K | $57.1K | $21.31 | 4.08x |
| 76512 | 2d ultrasound scan of eye tissue and structures | 373 | $26.5K | $71.04 | 2.83x |
This provider submits charges 2.42 times higher than what Medicare actually pays.
A markup ratio of 2.42x means for every $100 Medicare pays, this provider initially charges $242. 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 MD for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Michael Elman, M.D. | Baltimore, MD | $68.5M | ✓ Clear |
| David Warrow, M.D. | Hagerstown, MD | $65.5M | ✓ Clear |
| Raymond Sjaarda, M.D. | Baltimore, MD | $47.2M | ✓ Clear |
| Allen Hu, MD | Hagerstown, MD | $45.7M | ✓ Clear |
| James Rial, M.D. | Salisbury, MD | $45.2M | ✓ 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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