This provider's $5.9M in total Medicare payments ranks in the 97th 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 | $840.89 | $150.47 | 5.59x | $690.42 | $506.4K | 4.4K | 3.1K |
| 2015 | $840.08 | $174.45 | 4.82x | $665.63 | $539.6K | 4.8K | 3.3K |
| 2016 | $742.75 | $137.32 | 5.41x | $605.43 | $503.4K | 4.6K | 3.2K |
| 2017 | $519.38 | $155.03 | 3.35x | $364.35 | $533.7K | 4.6K | 3.2K |
| 2018 | $388.84 | $147.21 | 2.64x | $241.63 | $527.0K | 4.5K | 3.2K |
| 2019 | $217.00 | $158.92 | 1.37x | $58.08 | $660.0K | 4.7K | 3.2K |
| 2020 | $183.33 | $125.67 | 1.46x | $57.66 | $580.3K | 3.6K | 2.5K |
| 2021 | $202.16 | $153.70 | 1.32x | $48.46 | $784.4K | 4.6K | 3.1K |
| 2022 | $187.21 | $132.74 | 1.41x | $54.47 | $630.6K | 4.3K | 2.9K |
| 2023 | $189.30 | $132.05 | 1.43x | $57.25 | $616.5K | 4.6K | 3.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66762 | Creation of openings in iris for eye fluid drainage using laser, 1 or more sessions | 5.7K | $2.5M | $447.04 | 2.12x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 5.5K | $767.2K | $139.92 | 5.70x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 6.8K | $691.9K | $101.25 | 1.83x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 5.3K | $399.5K | $75.90 | 2.03x |
| 68110 | Removal of (up to 1 centimeter) growth of sclera | 975 | $210.1K | $215.49 | 2.86x |
| 67961 | Removal of up to one-fourth of the eyelid involving lid margin | 314 | $168.4K | $536.34 | 1.49x |
| 92083 | Measurement of field of vision during daylight conditions | 2.4K | $135.0K | $56.77 | 1.92x |
| 92250 | Photography of the retina | 2.4K | $130.3K | $54.62 | 2.78x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 3.0K | $98.4K | $33.00 | 4.05x |
| 92020 | Examination of cornea and iris using lens device and slit lamp | 4.2K | $97.4K | $23.36 | 5.59x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 893 | $85.6K | $95.81 | 2.25x |
| 68801 | Dilation of tear-drainage opening | 1.2K | $77.1K | $64.51 | 4.67x |
| 66984 | Removal of cataract with insertion of lens | 123 | $69.4K | $564.63 | 5.34x |
| 67840 | Removal of eyelid growth | 232 | $62.5K | $269.50 | 1.28x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 383 | $45.7K | $119.35 | 1.94x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 202 | $41.1K | $203.28 | 1.00x |
| 65210 | Removal of foreign body in external eye, conjunctiva or sclera | 556 | $34.3K | $61.76 | 3.87x |
| 68761 | Closure of tear duct opening using plug | 303 | $32.2K | $106.25 | 3.53x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 217 | $28.3K | $130.25 | 1.52x |
| 92202 | Extended examination of eye with drawing of optic nerve and surrounding area (macula) | 2.0K | $27.0K | $13.33 | 1.42x |
This provider submits charges 2.75 times higher than what Medicare actually pays.
A markup ratio of 2.75x means for every $100 Medicare pays, this provider initially charges $275. 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 NY for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Jonathan Jonisch, MD | Great Neck, NY | $52.3M | ✓ Clear |
| Jeffrey Josef, M.D. | Suffern, NY | $52.2M | ✓ Clear |
| Brett Rosenblatt | Great Neck, NY | $50.0M | ✓ Clear |
| Kenneth Graham | Great Neck, NY | $47.1M | ✓ Clear |
| Glenn Stoller, M.D. | Rockville Centre, NY | $46.4M | ✓ 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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