This provider averages 85 services per working day
Based on 213.0K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $26.5M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 85 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 81% 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 | $253.30 | $97.42 | 2.60x | $155.88 | $1.7M | 17.9K | 21 |
| 2015 | $267.20 | $107.46 | 2.49x | $159.74 | $1.9M | 17.7K | 20 |
| 2016 | $321.08 | $127.48 | 2.52x | $193.60 | $2.2M | 17.1K | 23 |
| 2017 | $290.67 | $128.75 | 2.26x | $161.92 | $2.4M | 19.0K | 25 |
| 2018 | $254.02 | $131.89 | 1.93x | $122.13 | $2.5M | 18.9K | 20 |
| 2019 | $259.55 | $133.50 | 1.94x | $126.05 | $2.8M | 20.7K | 17 |
| 2020 | $304.58 | $160.49 | 1.90x | $144.09 | $3.1M | 19.5K | 21 |
| 2021 | $315.89 | $162.84 | 1.94x | $153.05 | $3.6M | 21.9K | 19 |
| 2022 | $313.97 | $149.11 | 2.11x | $164.86 | $3.2M | 21.3K | 19 |
| 2023 | $199.70 | $80.87 | 2.47x | $118.83 | $3.2M | 39.1K | 19 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2778 | Injection, ranibizumab, 0.1 mg | 48.3K | $12.7M | $263.46 | 1.57x |
| J0178 | Injection, aflibercept, 1 mg | 8.5K | $6.2M | $729.56 | 1.35x |
| 92014 | Established patient complete exam of visual system | 15.1K | $1.3M | $88.28 | 3.06x |
| 67028 | Injection of drug into eye | 15.2K | $1.3M | $85.56 | 5.57x |
| 92134 | Imaging of retina | 28.9K | $898.3K | $31.12 | 3.57x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 7.6K | $652.1K | $85.56 | 4.18x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 19.4K | $556.3K | $28.70 | 3.19x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 23.5K | $446.8K | $19.03 | 4.57x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 330 | $313.3K | $949.27 | 4.61x |
| 92250 | Photography of the retina | 6.1K | $251.5K | $41.15 | 3.70x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 1.4K | $216.5K | $153.73 | 2.55x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 2.1K | $184.5K | $86.39 | 3.33x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.4K | $173.9K | $120.32 | 2.79x |
| 76512 | 2d ultrasound scan of eye tissue and structures | 3.9K | $153.0K | $39.42 | 3.82x |
| J9035 | Injection, bevacizumab, 10 mg | 2.6K | $139.6K | $53.26 | 1.33x |
| 92004 | New patient complete exam of visual system | 1.2K | $128.5K | $106.23 | 3.54x |
| 92020 | Exam of the internal drainage system of eye | 5.4K | $114.2K | $21.19 | 3.46x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 2.0K | $103.6K | $52.36 | 2.10x |
| 67210 | Destruction of growth of retina using a laser | 236 | $94.5K | $400.27 | 4.19x |
| 92201 | Extended exam of the back part of the eye with retinal drawing | 4.3K | $80.2K | $18.88 | 3.27x |
This provider submits charges 2.18 times higher than what Medicare actually pays.
A markup ratio of 2.18x means for every $100 Medicare pays, this provider initially charges $218. 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 TX for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Jason Ysasaga, M.D. | Amarillo, TX | $61.5M | ✓ Clear |
| Harshivinderjit Bains, MD | Tyler, TX | $53.9M | ✓ Clear |
| Ryan Rush, MD | Amarillo, TX | $53.6M | ✓ Clear |
| Tien Wong, M.D. | Houston, TX | $51.2M | ✓ Clear |
| Thomas Bochow, M.D., M.P.H. | Tyler, TX | $49.4M | ✓ Clear |
Share this provider's Medicare payment information
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.
Believe this data is inaccurate? Dispute this data