This provider averages 80 services per working day
Based on 200.0K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $49.1M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 80 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 58% 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 | $487.94 | $218.10 | 2.24x | $269.84 | $3.6M | 16.5K | 16 |
| 2015 | $562.43 | $247.27 | 2.27x | $315.16 | $4.1M | 16.6K | 18 |
| 2016 | $580.60 | $254.60 | 2.28x | $326.00 | $4.9M | 19.4K | 19 |
| 2017 | $563.05 | $246.87 | 2.28x | $316.18 | $4.7M | 18.9K | 15 |
| 2018 | $522.32 | $228.51 | 2.29x | $293.81 | $5.2M | 22.7K | 14 |
| 2019 | $529.98 | $223.69 | 2.37x | $306.29 | $5.8M | 26.0K | 14 |
| 2020 | $549.13 | $225.07 | 2.44x | $324.06 | $5.4M | 23.8K | 12 |
| 2021 | $567.61 | $228.44 | 2.48x | $339.17 | $5.2M | 22.9K | 13 |
| 2022 | $727.12 | $288.17 | 2.52x | $438.95 | $4.5M | 15.8K | 11 |
| 2023 | $1.3K | $326.23 | 3.93x | $955.50 | $5.7M | 17.3K | 16 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2778 | Injection, ranibizumab, 0.1 mg | 82.8K | $23.0M | $278.30 | 2.16x |
| J0178 | Injection, aflibercept, 1 mg | 24.1K | $17.8M | $737.85 | 2.28x |
| 67028 | Injection of drug into eye | 24.0K | $2.2M | $92.50 | 5.64x |
| 92014 | Established patient complete exam of visual system | 13.7K | $1.2M | $89.24 | 2.58x |
| 92134 | Imaging of retina | 32.9K | $1.0M | $31.17 | 4.68x |
| J3490 | Unclassified drugs | 465 | $934.0K | $2.0K | 3.90x |
| J3590 | Unclassified biologics | 454 | $922.7K | $2.0K | 3.78x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 4.1K | $491.1K | $120.36 | 3.75x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 1.6K | $350.7K | $217.70 | 3.86x |
| 92012 | Established patient problem focused exam of visual system | 3.6K | $221.3K | $61.24 | 1.98x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.9K | $218.9K | $117.02 | 2.67x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 2.8K | $217.7K | $77.62 | 3.71x |
| 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 | 469 | $91.1K | $194.19 | 3.09x |
| 92250 | Photography of the retina | 1.7K | $71.3K | $41.18 | 3.87x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 82 | $42.5K | $518.66 | 5.56x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 2.3K | $41.5K | $18.37 | 2.45x |
| 92004 | New patient complete exam of visual system | 382 | $39.9K | $104.33 | 2.67x |
| J9035 | Injection, bevacizumab, 10 mg | 607 | $34.3K | $56.48 | 4.73x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 1.3K | $27.9K | $20.86 | 2.40x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 69 | $27.6K | $399.96 | 4.60x |
This provider submits charges 2.54 times higher than what Medicare actually pays.
A markup ratio of 2.54x means for every $100 Medicare pays, this provider initially charges $254. 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 |
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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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