This provider averages 78 services per working day
Based on 194.6K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $24.6M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 78 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 93% from 2014 to 2023.
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 | $472.27 | $134.06 | 3.52x | $338.21 | $1.6M | 11.8K | 21 |
| 2015 | $576.57 | $156.92 | 3.67x | $419.65 | $1.9M | 12.2K | 17 |
| 2016 | $653.15 | $173.03 | 3.77x | $480.12 | $2.3M | 13.5K | 21 |
| 2017 | $690.14 | $176.88 | 3.90x | $513.26 | $2.3M | 12.8K | 22 |
| 2018 | $702.14 | $178.48 | 3.93x | $523.66 | $2.8M | 15.5K | 24 |
| 2019 | $741.10 | $183.18 | 4.05x | $557.92 | $2.5M | 13.8K | 19 |
| 2020 | $812.27 | $194.30 | 4.18x | $617.97 | $2.7M | 14.0K | 19 |
| 2021 | $810.29 | $184.29 | 4.40x | $626.00 | $2.7M | 14.9K | 15 |
| 2022 | $618.23 | $130.70 | 4.73x | $487.53 | $2.7M | 20.3K | 16 |
| 2023 | $207.51 | $46.42 | 4.47x | $161.09 | $3.1M | 65.9K | 15 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 12.1K | $9.0M | $742.32 | 4.05x |
| J2778 | Injection, ranibizumab, 0.1 mg | 25.2K | $6.6M | $260.70 | 4.74x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 61.6K | $1.8M | $28.93 | 4.02x |
| 67028 | Injection of drug into eye | 19.4K | $1.8M | $91.08 | 4.72x |
| 92134 | Imaging of retina | 24.0K | $773.3K | $32.25 | 3.24x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 8.9K | $714.6K | $80.69 | 3.11x |
| 92012 | Established patient problem focused exam of visual system | 10.8K | $688.9K | $63.95 | 3.10x |
| 92014 | Established patient complete exam of visual system | 5.8K | $528.0K | $90.28 | 3.50x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 2.5K | $387.4K | $156.32 | 2.96x |
| J9035 | Injection, bevacizumab, 10 mg | 6.9K | $386.7K | $56.11 | 3.73x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 386 | $368.1K | $953.68 | 3.39x |
| 92250 | Photography of the retina | 7.4K | $311.4K | $42.32 | 3.51x |
| J7999 | Compounded drug, not otherwise classified | 3.1K | $218.6K | $70.67 | 3.80x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 183 | $188.9K | $1.0K | 3.28x |
| 92004 | New patient complete exam of visual system | 1.5K | $160.0K | $107.05 | 2.86x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 218 | $156.6K | $718.20 | 3.13x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 510 | $126.2K | $247.53 | 4.12x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 958 | $114.9K | $119.95 | 3.64x |
| 92242 | Imaging of blood vessels in back of eye using fluorescein and indocyanine-green dye | 416 | $73.9K | $177.72 | 2.68x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 140 | $61.6K | $439.86 | 4.36x |
This provider submits charges 4.11 times higher than what Medicare actually pays.
A markup ratio of 4.11x means for every $100 Medicare pays, this provider initially charges $411. This is higher than the national average.
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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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