This provider averages 81 services per working day
Based on 203.0K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $36.1M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 81 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 64% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 72% in 2015
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 | $382.95 | $134.00 | 2.86x | $248.95 | $2.1M | 15.4K | 23 |
| 2015 | $480.97 | $155.68 | 3.09x | $325.29 | $3.5M | 22.7K | 22 |
| 2016 | $541.48 | $167.79 | 3.23x | $373.69 | $3.9M | 23.3K | 21 |
| 2017 | $575.07 | $174.53 | 3.29x | $400.54 | $3.9M | 22.5K | 22 |
| 2018 | $625.30 | $181.23 | 3.45x | $444.07 | $4.6M | 25.4K | 19 |
| 2019 | $720.27 | $189.39 | 3.80x | $530.88 | $4.0M | 21.2K | 15 |
| 2020 | $896.95 | $231.98 | 3.87x | $664.97 | $3.6M | 15.4K | 15 |
| 2021 | $879.94 | $225.23 | 3.91x | $654.71 | $3.7M | 16.6K | 15 |
| 2022 | $878.02 | $211.30 | 4.16x | $666.72 | $3.4M | 16.1K | 14 |
| 2023 | $597.90 | $137.92 | 4.34x | $459.98 | $3.4M | 24.4K | 18 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 22.5K | $16.5M | $735.11 | 3.40x |
| J2778 | Injection, ranibizumab, 0.1 mg | 39.5K | $10.8M | $274.18 | 3.09x |
| 92014 | Established patient complete exam of visual system | 28.6K | $2.9M | $102.81 | 2.96x |
| 67028 | Injection of drug into eye | 21.1K | $2.0M | $93.65 | 5.76x |
| 92134 | Imaging of retina | 30.5K | $1.1M | $37.06 | 9.14x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 25.0K | $544.1K | $21.73 | 3.87x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 3.2K | $416.8K | $130.09 | 3.10x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 8.8K | $256.3K | $29.06 | 4.30x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 1.9K | $171.7K | $90.77 | 3.82x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 5.2K | $122.0K | $23.67 | 3.59x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 550 | $118.1K | $214.82 | 4.66x |
| J3590 | Unclassified biologics | 51 | $109.8K | $2.2K | 3.08x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 178 | $101.1K | $568.08 | 5.01x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 630 | $97.5K | $154.80 | 2.77x |
| J9035 | Injection, bevacizumab, 10 mg | 1.5K | $85.4K | $56.53 | 6.63x |
| 92250 | Photography of the retina | 1.6K | $80.9K | $52.18 | 3.70x |
| 92012 | Established patient problem focused exam of visual system | 996 | $75.1K | $75.36 | 2.73x |
| 67042 | Removal of membrane from the retina, pars plana approach | 63 | $62.7K | $995.93 | 3.58x |
| 92202 | Extended exam of the back part of the eye with optic nerve drawing | 4.3K | $58.1K | $13.59 | 6.14x |
| 76512 | 2d ultrasound scan of eye tissue and structures | 814 | $56.5K | $69.43 | 3.78x |
This provider submits charges 3.62 times higher than what Medicare actually pays.
A markup ratio of 3.62x means for every $100 Medicare pays, this provider initially charges $362. 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 |
| Leonard Feiner, M.D | Union, NJ | $36.0M | ✓ 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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