This provider's $3.8M in total Medicare payments ranks in the 95th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 77% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 339% in 2017
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 | $330.50 | $115.81 | 2.85x | $214.69 | $337.9K | 3.3K | 977 |
| 2015 | $391.06 | $128.76 | 3.04x | $262.30 | $41.6K | 412 | 347 |
| 2016 | $267.80 | $71.15 | 3.76x | $196.65 | $45.9K | 727 | 389 |
| 2017 | $119.13 | $54.84 | 2.17x | $64.29 | $201.3K | 4.0K | 1.4K |
| 2018 | $368.25 | $132.89 | 2.77x | $235.36 | $445.9K | 5.6K | 1.5K |
| 2019 | $462.40 | $179.78 | 2.57x | $282.62 | $614.7K | 5.8K | 1.5K |
| 2020 | $319.43 | $127.74 | 2.50x | $191.69 | $628.0K | 5.6K | 1.2K |
| 2021 | $332.92 | $127.78 | 2.61x | $205.14 | $490.3K | 5.2K | 1.3K |
| 2022 | $384.24 | $135.84 | 2.83x | $248.40 | $359.5K | 4.5K | 1.2K |
| 2023 | $410.36 | $121.17 | 3.39x | $289.19 | $599.7K | 5.8K | 1.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 2.0K | $1.5M | $731.31 | 2.69x |
| 67028 | Injection of drug into eye | 8.1K | $714.2K | $88.20 | 3.96x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 6.9K | $647.2K | $93.87 | 2.27x |
| 92134 | Diagnostic imaging of retina | 10.4K | $321.6K | $30.98 | 3.34x |
| J9035 | Injection, bevacizumab, 10 mg | 5.5K | $283.4K | $51.49 | 2.08x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.7K | $155.8K | $93.82 | 2.58x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 2.2K | $41.0K | $18.70 | 2.74x |
| 92202 | Extended examination of eye with drawing of optic nerve and surrounding area (macula) | 2.6K | $32.3K | $12.27 | 4.27x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 255 | $28.2K | $110.48 | 2.61x |
| 67042 | Removal of membrane from the retina, pars plana approach | 24 | $22.7K | $945.04 | 2.50x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 155 | $18.4K | $118.52 | 2.99x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 530 | $11.2K | $21.05 | 2.65x |
| J3590 | Unclassified biologics | 127 | $6.6K | $51.80 | 2.41x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 60 | $4.6K | $76.01 | 3.65x |
| 92250 | Photography of the retina | 76 | $4.1K | $54.55 | 3.42x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 59 | $3.6K | $61.46 | 2.55x |
| 92201 | Extended examination of eye with drawing of retina | 116 | $2.1K | $18.13 | 2.72x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 17 | $985.00 | $57.94 | 1.35x |
| 76512 | Ultrasound of eye disease, growth, or structure | 14 | $697.90 | $49.85 | 2.51x |
| J3300 | Injection, triamcinolone acetonide, preservative free, 1 mg | 147 | $424.68 | $2.89 | 48.22x |
This provider submits charges 2.88 times higher than what Medicare actually pays.
A markup ratio of 2.88x means for every $100 Medicare pays, this provider initially charges $288. 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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