⚠️ This provider averages 266 services per working day — physically unusual for an individual practitioner
Based on 664.1K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $61.5M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 266 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 122% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 96% in 2018
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 |
|---|---|---|---|---|---|---|---|
| 2014 | $304.55 | $83.10 | 3.66x | $221.45 | $4.5M | 53.7K | 25 |
| 2015 | $280.00 | $74.80 | 3.74x | $205.20 | $3.8M | 51.0K | 26 |
| 2016 | $238.04 | $58.71 | 4.05x | $179.33 | $3.5M | 60.1K | 27 |
| 2017 | $289.42 | $72.21 | 4.01x | $217.21 | $3.3M | 45.4K | 25 |
| 2018 | $364.06 | $118.87 | 3.06x | $245.19 | $6.4M | 54.2K | 27 |
| 2019 | $440.99 | $151.62 | 2.91x | $289.37 | $8.1M | 53.6K | 26 |
| 2020 | $530.96 | $189.33 | 2.80x | $341.63 | $7.6M | 40.1K | 22 |
| 2021 | $517.99 | $179.90 | 2.88x | $338.09 | $7.4M | 41.2K | 24 |
| 2022 | $326.49 | $112.56 | 2.90x | $213.93 | $6.9M | 61.7K | 28 |
| 2023 | $152.59 | $48.88 | 3.12x | $103.71 | $9.9M | 203.0K | 32 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 18.3K | $13.6M | $745.90 | 2.01x |
| J2778 | Injection, ranibizumab, 0.1 mg | 48.9K | $12.8M | $260.90 | 1.92x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 192.3K | $5.6M | $29.13 | 2.07x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 50.4K | $3.9M | $77.19 | 4.08x |
| 92240 | Exam of blood vessels between the white part of eye and retina using a special camera after injection of a dye | 18.5K | $3.0M | $162.65 | 3.54x |
| 67028 | Injection of drug into eye | 35.4K | $2.8M | $79.64 | 8.52x |
| 92014 | Established patient complete exam of visual system | 27.4K | $2.3M | $84.10 | 3.57x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 27.7K | $2.3M | $81.48 | 3.45x |
| J3590 | Unclassified biologics | 1.2K | $2.0M | $1.7K | 1.92x |
| J3490 | Unclassified drugs | 986 | $1.7M | $1.8K | 4.26x |
| 67210 | Destruction of growth of retina using a laser | 3.8K | $1.5M | $388.42 | 4.18x |
| 92250 | Photography of the retina | 32.7K | $1.4M | $42.23 | 4.38x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 69.0K | $1.3M | $18.71 | 8.02x |
| 92242 | Exam of retinal blood vessels and blood vessels between the white part of eye and retina using a special camera after injection of a dye | 6.2K | $1.1M | $175.90 | 3.41x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 989 | $903.7K | $913.77 | 5.03x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 2.5K | $793.7K | $321.20 | 8.52x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 5.5K | $663.4K | $119.85 | 1.67x |
| 92134 | Imaging of retina | 19.9K | $578.3K | $29.06 | 5.51x |
| J3396 | Injection, verteporfin, 0.1 mg | 60.6K | $508.7K | $8.39 | 2.39x |
| 67113 | Complex repair of detached retina and drainage of eye fluid between lens and retina | 406 | $436.1K | $1.1K | 4.05x |
This provider submits charges 3.17 times higher than what Medicare actually pays.
A markup ratio of 3.17x means for every $100 Medicare pays, this provider initially charges $317. 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 |
|---|---|---|---|
| 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 |
| David Brown, M.D. | Houston, TX | $49.1M | ✓ 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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