This provider's $11.1M in total Medicare payments ranks in the 98th percentile of Ophthalmology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $506.54 | $154.31 | 3.28x | $352.23 | $985.5K | 8.3K | 3.3K |
| 2015 | $537.82 | $171.03 | 3.14x | $366.79 | $1.1M | 9.1K | 3.3K |
| 2016 | $478.10 | $129.93 | 3.68x | $348.17 | $1.0M | 8.4K | 3.4K |
| 2017 | $458.22 | $128.37 | 3.57x | $329.85 | $1.0M | 9.1K | 3.3K |
| 2018 | $507.59 | $141.72 | 3.58x | $365.87 | $1.1M | 9.3K | 3.1K |
| 2019 | $498.06 | $137.29 | 3.63x | $360.77 | $1.2M | 9.9K | 3.4K |
| 2020 | $572.19 | $155.02 | 3.69x | $417.17 | $1.1M | 8.7K | 3.1K |
| 2021 | $351.78 | $123.55 | 2.85x | $228.23 | $1.1M | 8.1K | 2.6K |
| 2022 | $443.66 | $142.64 | 3.11x | $301.02 | $1.1M | 7.4K | 2.6K |
| 2023 | $1.3K | $337.30 | 4.00x | $1.0K | $1.2M | 6.9K | 2.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 4.9K | $3.6M | $733.30 | 2.30x |
| J2778 | Injection, ranibizumab, 0.1 mg | 9.4K | $2.7M | $282.11 | 2.14x |
| 67028 | Injection of drug into eye | 16.6K | $1.4M | $86.78 | 5.51x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 13.4K | $1.2M | $91.33 | 2.58x |
| 92134 | Diagnostic imaging of retina | 23.8K | $726.7K | $30.60 | 4.77x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 4.8K | $284.4K | $59.81 | 2.00x |
| J3590 | Unclassified biologics | 84 | $172.7K | $2.1K | 3.89x |
| 92250 | Photography of the retina | 3.8K | $151.9K | $39.85 | 4.02x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 1.9K | $145.7K | $78.39 | 3.71x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.1K | $124.6K | $116.82 | 2.64x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 217 | $97.9K | $451.12 | 6.40x |
| J9035 | Injection, bevacizumab, 10 mg | 1.5K | $85.4K | $55.15 | 4.78x |
| 65800 | Aspiration of eye fluid | 896 | $82.8K | $92.47 | 6.60x |
| J3490 | Unclassified drugs | 34 | $61.7K | $1.8K | 4.02x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 307 | $32.0K | $104.36 | 2.66x |
| J7999 | Compounded drug, not otherwise classified | 458 | $30.2K | $66.01 | 4.61x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 296 | $29.5K | $99.52 | 2.51x |
| 67145 | Preventive retinal detachment treatment by heat or laser, 1 or more sessions | 75 | $26.6K | $354.34 | 3.51x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 261 | $23.6K | $90.42 | 3.07x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 98 | $21.4K | $217.87 | 3.86x |
This provider submits charges 3.06 times higher than what Medicare actually pays.
A markup ratio of 3.06x means for every $100 Medicare pays, this provider initially charges $306. 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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