This provider's $16.8M in total Medicare payments ranks in the 99th 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 โ the gap represents the markup.
| Year | Avg Submitted | Avg Paid | Markup Ratio | Gap per Service | Total Payments | Services | Beneficiaries |
|---|---|---|---|---|---|---|---|
| 2014 | $946.42 | $330.83 | 2.86x | $615.59 | $2.3M | 15.9K | 7.2K |
| 2015 | $660.00 | $234.13 | 2.82x | $425.87 | $2.3M | 15.8K | 6.8K |
| 2016 | $862.53 | $241.04 | 3.58x | $621.49 | $2.2M | 15.4K | 6.9K |
| 2017 | $870.83 | $238.78 | 3.65x | $632.05 | $2.2M | 15.2K | 6.7K |
| 2018 | $255.30 | $131.21 | 1.95x | $124.09 | $1.5M | 10.9K | 4.7K |
| 2019 | $685.91 | $265.94 | 2.58x | $419.97 | $1.5M | 10.3K | 4.3K |
| 2020 | $292.93 | $140.52 | 2.08x | $152.41 | $1.1M | 7.7K | 3.3K |
| 2021 | $685.38 | $203.97 | 3.36x | $481.41 | $1.2M | 7.9K | 3.3K |
| 2022 | $643.78 | $243.29 | 2.65x | $400.49 | $1.3M | 7.9K | 3.2K |
| 2023 | $656.64 | $316.29 | 2.08x | $340.35 | $1.0M | 7.4K | 3.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 12.0K | $9.0M | $748.51 | 1.50x |
| 67028 | Injection of drug into eye | 17.7K | $1.7M | $93.61 | 6.60x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 17.3K | $1.2M | $70.88 | 2.07x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 10.2K | $990.7K | $96.96 | 1.93x |
| J2778 | Injection, ranibizumab, 0.1 mg | 3.4K | $985.8K | $291.56 | 1.56x |
| 92134 | Diagnostic imaging of retina | 22.6K | $799.1K | $35.37 | 3.00x |
| 92250 | Photography of the retina | 7.4K | $407.4K | $54.79 | 2.53x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 11.4K | $323.3K | $28.44 | 2.23x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 2.3K | $305.2K | $130.41 | 3.15x |
| J3590 | Unclassified biologics | 158 | $285.3K | $1.8K | 2.09x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.7K | $226.2K | $132.77 | 1.88x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 318 | $79.0K | $248.36 | 1.50x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 69 | $78.1K | $1.1K | 4.86x |
| 67042 | Removal of membrane from the retina, pars plana approach | 67 | $71.7K | $1.1K | 5.14x |
| J9035 | Injection, bevacizumab, 10 mg | 1.2K | $67.1K | $57.14 | 1.57x |
| J3490 | Unclassified drugs | 32 | $55.0K | $1.7K | 1.75x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 100 | $54.0K | $540.31 | 1.81x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 1.3K | $45.5K | $35.06 | 2.00x |
| 76512 | Ultrasound of eye disease, growth, or structure | 635 | $42.8K | $67.48 | 3.20x |
| 92202 | Extended examination of eye with drawing of optic nerve and surrounding area (macula) | 2.7K | $34.7K | $12.97 | 3.66x |
This provider submits charges 2.28 times higher than what Medicare actually pays.
A markup ratio of 2.28x means for every $100 Medicare pays, this provider initially charges $228. 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 CT for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Nauman Chaudhry, M.D. | Waterford, CT | $48.4M | โ Clear |
| Ron Margolis, M.D. | Manchester, CT | $39.2M | โ Clear |
| Marion Stoj, M.D. | Manchester, CT | $34.8M | โ Clear |
| Michael Ruddat, MD | Hartford, CT | $34.1M | โ 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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