This provider's $12.7M in total Medicare payments ranks in the 98th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 3904% from 2018 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 853% in 2021
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 |
|---|---|---|---|---|---|---|---|
| 2018 | $592.51 | $156.09 | 3.80x | $436.42 | $131.3K | 841 | 10 |
| 2019 | $459.65 | $127.20 | 3.61x | $332.45 | $146.1K | 1.1K | 14 |
| 2020 | $790.17 | $217.89 | 3.63x | $572.28 | $268.4K | 1.2K | 13 |
| 2021 | $805.02 | $224.24 | 3.59x | $580.78 | $2.6M | 11.4K | 19 |
| 2022 | $818.15 | $213.60 | 3.83x | $604.55 | $4.3M | 20.3K | 20 |
| 2023 | $661.49 | $169.54 | 3.90x | $491.95 | $5.3M | 31.0K | 18 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 8.0K | $5.7M | $711.74 | 3.42x |
| J2778 | Injection, ranibizumab, 0.1 mg | 16.3K | $3.6M | $219.64 | 4.10x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 4.2K | $914.6K | $215.65 | 3.71x |
| 67028 | Injection of drug into eye | 7.4K | $734.6K | $99.35 | 4.62x |
| 92134 | Imaging of retina | 12.4K | $393.4K | $31.60 | 4.58x |
| 92012 | Established patient problem focused exam of visual system | 4.9K | $335.9K | $68.83 | 2.83x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 6.6K | $191.7K | $29.05 | 2.51x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.4K | $180.4K | $127.52 | 2.78x |
| 92014 | Established patient complete exam of visual system | 1.8K | $161.3K | $88.40 | 3.11x |
| 67113 | Complex repair of detached retina and drainage of eye fluid between lens and retina | 143 | $108.7K | $760.20 | 6.64x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 177 | $89.2K | $503.95 | 6.21x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 126 | $71.1K | $564.05 | 6.51x |
| 67039 | Destruction of eye fluid (vitreous) between lens and retina using a laser | 94 | $53.8K | $572.70 | 6.60x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 111 | $33.3K | $299.88 | 7.91x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 74 | $29.9K | $404.40 | 5.42x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 462 | $25.8K | $55.87 | 2.17x |
| J7999 | Compounded drug, not otherwise classified | 285 | $21.1K | $74.18 | 6.05x |
| 92004 | New patient complete exam of visual system | 165 | $18.1K | $109.63 | 3.01x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 178 | $15.4K | $86.30 | 2.37x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 28 | $8.5K | $302.26 | 17.51x |
This provider submits charges 3.8 times higher than what Medicare actually pays.
A markup ratio of 3.8x means for every $100 Medicare pays, this provider initially charges $380. 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 PA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Richard Kaiser, MD | Plymouth Meeting, PA | $75.2M | ✓ Clear |
| Allen Ho, MD | Plymouth Meeting, PA | $67.7M | ✓ Clear |
| Carl Regillo, MD | Plymouth Meeting, PA | $63.5M | ✓ Clear |
| Marc Spirn, MD | Plymouth Meeting, PA | $63.4M | ✓ Clear |
| Mitchell Fineman, MD | Plymouth Meeting, PA | $61.7M | ✓ 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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