This provider's $8.1M in total Medicare payments ranks in the 98th percentile of Ophthalmology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $545.70 | $199.29 | 2.74x | $346.41 | $964.4K | 6.7K | 2.3K |
| 2015 | $672.10 | $208.45 | 3.22x | $463.65 | $1.0M | 6.1K | 2.0K |
| 2016 | $927.45 | $268.82 | 3.45x | $658.63 | $983.5K | 5.5K | 1.8K |
| 2017 | $990.61 | $277.92 | 3.56x | $712.69 | $857.7K | 4.8K | 1.7K |
| 2018 | $993.52 | $275.87 | 3.60x | $717.65 | $877.3K | 4.5K | 1.5K |
| 2019 | $1.2K | $389.26 | 3.13x | $828.95 | $831.6K | 4.3K | 1.6K |
| 2020 | $1.1K | $294.95 | 3.58x | $762.32 | $596.9K | 3.6K | 1.3K |
| 2021 | $868.18 | $248.71 | 3.49x | $619.47 | $679.3K | 3.9K | 1.4K |
| 2022 | $736.30 | $215.47 | 3.42x | $520.83 | $681.4K | 4.3K | 1.5K |
| 2023 | $755.56 | $241.67 | 3.13x | $513.89 | $568.5K | 4.4K | 1.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 6.0K | $4.5M | $750.24 | 2.27x |
| 67028 | Injection of drug into eye | 11.2K | $959.9K | $85.82 | 5.77x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 8.2K | $693.9K | $84.81 | 1.92x |
| J2778 | Injection, ranibizumab, 0.1 mg | 1.7K | $518.3K | $302.01 | 2.36x |
| 92134 | Diagnostic imaging of retina | 15.3K | $476.5K | $31.12 | 4.49x |
| 67042 | Removal of membrane from the retina, pars plana approach | 209 | $183.2K | $876.50 | 4.34x |
| J3490 | Unclassified drugs | 79 | $122.5K | $1.6K | 3.21x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 420 | $104.9K | $249.84 | 2.20x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 995 | $99.8K | $100.33 | 2.03x |
| J7999 | Compounded drug, not otherwise classified | 1.2K | $78.6K | $63.18 | 4.75x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 87 | $77.6K | $891.44 | 4.37x |
| J3590 | Unclassified biologics | 230 | $59.9K | $260.33 | 2.10x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 79 | $44.5K | $562.84 | 3.46x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 236 | $25.9K | $109.60 | 2.24x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 609 | $17.8K | $29.20 | 2.16x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 232 | $17.1K | $73.76 | 2.78x |
| J9035 | Injection, bevacizumab, 10 mg | 310 | $15.8K | $51.13 | 1.94x |
| 92250 | Photography of the retina | 211 | $9.8K | $46.68 | 2.71x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 104 | $8.2K | $78.41 | 2.01x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 61 | $7.3K | $120.36 | 2.16x |
This provider submits charges 2.9 times higher than what Medicare actually pays.
A markup ratio of 2.9x means for every $100 Medicare pays, this provider initially charges $290. 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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