This provider averages 65 services per working day
Based on 163.7K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $28.2M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 65 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 113% 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 | $310.56 | $129.88 | 2.39x | $180.68 | $2.2M | 17.1K | 26 |
| 2015 | $327.02 | $133.12 | 2.46x | $193.90 | $1.9M | 14.6K | 23 |
| 2016 | $360.12 | $139.84 | 2.58x | $220.28 | $2.2M | 15.6K | 24 |
| 2017 | $414.72 | $157.83 | 2.63x | $256.89 | $2.3M | 14.7K | 24 |
| 2018 | $450.42 | $172.89 | 2.61x | $277.53 | $2.7M | 15.5K | 24 |
| 2019 | $436.96 | $170.11 | 2.57x | $266.85 | $2.5M | 14.5K | 25 |
| 2020 | $539.75 | $207.48 | 2.60x | $332.27 | $2.7M | 12.8K | 25 |
| 2021 | $588.95 | $232.32 | 2.54x | $356.63 | $3.5M | 15.2K | 25 |
| 2022 | $588.44 | $223.29 | 2.64x | $365.15 | $3.4M | 15.3K | 24 |
| 2023 | $445.63 | $166.86 | 2.67x | $278.77 | $4.8M | 28.5K | 25 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 21.3K | $15.6M | $731.90 | 2.46x |
| J2778 | Injection, ranibizumab, 0.1 mg | 10.4K | $3.0M | $289.40 | 2.08x |
| 67028 | Injection of drug into eye | 16.8K | $1.4M | $84.43 | 3.41x |
| 92014 | Established patient complete exam of visual system | 11.3K | $910.7K | $80.42 | 2.96x |
| 92134 | Imaging of retina | 28.1K | $751.8K | $26.78 | 3.05x |
| 67210 | Destruction of growth of retina using a laser | 1.8K | $689.2K | $389.39 | 2.86x |
| J3490 | Unclassified drugs | 330 | $581.8K | $1.8K | 2.63x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 7.2K | $530.8K | $74.18 | 3.36x |
| 92012 | Established patient problem focused exam of visual system | 8.4K | $517.0K | $61.83 | 2.70x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 514 | $465.8K | $906.31 | 2.57x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 2.9K | $456.3K | $157.41 | 2.54x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 3.5K | $415.2K | $120.36 | 2.56x |
| J3590 | Unclassified biologics | 5.9K | $368.4K | $61.92 | 2.77x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 4.9K | $363.3K | $74.26 | 2.06x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 10.7K | $313.1K | $29.15 | 2.60x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 814 | $270.7K | $332.50 | 5.37x |
| 92250 | Photography of the retina | 6.4K | $266.2K | $41.76 | 3.19x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 10.8K | $194.1K | $17.90 | 2.38x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.5K | $168.7K | $112.70 | 2.73x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 2.7K | $134.8K | $50.69 | 1.82x |
This provider submits charges 2.58 times higher than what Medicare actually pays.
A markup ratio of 2.58x means for every $100 Medicare pays, this provider initially charges $258. 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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