This provider averages 55 services per working day
Based on 137.4K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $13.0M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 55 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 | $1.5K | $347.90 | 4.20x | $1.1K | $1.5M | 15.4K | 8.7K |
| 2015 | $1.3K | $310.26 | 4.35x | $1.0K | $1.6M | 15.5K | 9.1K |
| 2016 | $1.3K | $244.55 | 5.25x | $1.0K | $1.6M | 16.9K | 9.8K |
| 2017 | $1.3K | $247.89 | 5.38x | $1.1K | $1.5M | 16.3K | 9.6K |
| 2018 | $1.3K | $221.50 | 5.65x | $1.0K | $1.3M | 15.1K | 8.5K |
| 2019 | $1.7K | $283.48 | 5.92x | $1.4K | $1.3M | 14.4K | 8.2K |
| 2020 | $1.3K | $260.31 | 5.16x | $1.1K | $967.6K | 10.3K | 5.9K |
| 2021 | $1.3K | $246.16 | 5.30x | $1.1K | $1.1M | 11.2K | 6.2K |
| 2022 | $1.4K | $255.35 | 5.47x | $1.1K | $1.0M | 10.9K | 6.0K |
| 2023 | $1.6K | $272.25 | 5.71x | $1.3K | $1.2M | 11.5K | 6.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 3.3K | $2.5M | $740.84 | 2.03x |
| 67028 | Injection of drug into eye | 15.5K | $1.3M | $85.42 | 6.93x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 13.2K | $1.3M | $98.83 | 1.77x |
| 92250 | Photography of the retina | 20.1K | $965.7K | $47.95 | 2.61x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 9.2K | $848.8K | $92.06 | 3.31x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.3K | $646.8K | $101.97 | 1.71x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 1.4K | $618.3K | $454.65 | 5.46x |
| J9035 | Injection, bevacizumab, 10 mg | 10.7K | $604.0K | $56.30 | 2.36x |
| 92240 | Examination of eye using an endoscope | 2.8K | $543.2K | $193.79 | 3.11x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 835 | $470.4K | $563.39 | 3.91x |
| 92134 | Diagnostic imaging of retina | 17.6K | $467.7K | $26.53 | 9.41x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 3.2K | $395.8K | $124.36 | 1.69x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 5.4K | $371.7K | $68.73 | 1.82x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 13.7K | $299.9K | $21.82 | 4.69x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 255 | $272.1K | $1.1K | 7.03x |
| 67042 | Removal of membrane from the retina, pars plana approach | 271 | $253.6K | $935.75 | 7.48x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 192 | $229.4K | $1.2K | 5.86x |
| 92287 | Imaging and evaluation of deep cells of the eye | 665 | $84.9K | $127.68 | 2.33x |
| 76512 | Ultrasound of eye disease, growth, or structure | 2.1K | $79.1K | $38.13 | 7.66x |
| 67220 | Destruction of vascular growth between retina and sclera, 1 or more sessions | 164 | $78.1K | $476.14 | 4.64x |
This provider submits charges 3.64 times higher than what Medicare actually pays.
A markup ratio of 3.64x means for every $100 Medicare pays, this provider initially charges $364. 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 NJ for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Howard Fine, MD MHSC | New Brunswick, NJ | $44.5M | ✓ Clear |
| Robert Barone, MD | Newton, NJ | $43.3M | ✓ Clear |
| Jonathan Prenner, MD | New Brunswick, NJ | $43.1M | ✓ Clear |
| Sumit Shah, M.D. | New Brunswick, NJ | $37.0M | ✓ Clear |
| David Kim, M.D. | Union, NJ | $36.1M | ✓ 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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