This provider averages 80 services per working day
Based on 200.4K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $26.7M 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 104% 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 | $494.40 | $153.44 | 3.22x | $340.96 | $1.7M | 11.0K | 23 |
| 2015 | $563.41 | $174.38 | 3.23x | $389.03 | $2.1M | 12.0K | 23 |
| 2016 | $590.62 | $177.56 | 3.33x | $413.06 | $2.1M | 12.0K | 20 |
| 2017 | $591.58 | $181.04 | 3.27x | $410.54 | $2.2M | 12.3K | 17 |
| 2018 | $665.47 | $207.00 | 3.21x | $458.47 | $2.6M | 12.8K | 18 |
| 2019 | $683.11 | $213.08 | 3.21x | $470.03 | $2.9M | 13.7K | 17 |
| 2020 | $780.85 | $233.32 | 3.35x | $547.53 | $3.1M | 13.1K | 18 |
| 2021 | $848.32 | $248.89 | 3.41x | $599.43 | $3.3M | 13.2K | 23 |
| 2022 | $443.17 | $127.23 | 3.48x | $315.94 | $3.3M | 25.5K | 25 |
| 2023 | $158.53 | $46.14 | 3.44x | $112.39 | $3.5M | 74.8K | 24 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 17.4K | $12.7M | $728.70 | 3.03x |
| J2778 | Injection, ranibizumab, 0.1 mg | 12.9K | $3.5M | $274.74 | 1.77x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 77.0K | $2.1M | $27.34 | 2.86x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 9.1K | $1.4M | $151.11 | 2.78x |
| 67028 | Injection of drug into eye | 14.0K | $1.2M | $86.94 | 12.79x |
| 92012 | Established patient problem focused exam of visual system | 15.5K | $944.6K | $60.83 | 2.27x |
| 92134 | Imaging of retina | 28.4K | $883.0K | $31.08 | 3.22x |
| 92014 | Established patient complete exam of visual system | 9.3K | $808.1K | $86.53 | 2.31x |
| J3590 | Unclassified biologics | 332 | $567.0K | $1.7K | 3.37x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 413 | $383.7K | $929.06 | 6.14x |
| J3490 | Unclassified drugs | 167 | $290.0K | $1.7K | 3.31x |
| 92004 | New patient complete exam of visual system | 2.6K | $277.1K | $106.44 | 2.58x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 358 | $255.9K | $714.80 | 5.60x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 836 | $194.2K | $232.26 | 3.01x |
| J7314 | Injection, fluocinolone acetonide, intravitreal implant (yutiq), 0.01 mg | 378 | $154.4K | $408.52 | 2.72x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 156 | $152.8K | $979.71 | 6.12x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 2.1K | $137.3K | $64.33 | 1.71x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 1.6K | $127.7K | $81.39 | 3.50x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 840 | $101.1K | $120.36 | 2.77x |
| J9035 | Injection, bevacizumab, 10 mg | 1.6K | $90.0K | $55.12 | 2.70x |
This provider submits charges 3.33 times higher than what Medicare actually pays.
A markup ratio of 3.33x means for every $100 Medicare pays, this provider initially charges $333. 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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