This provider averages 63 services per working day
Based on 142.7K total services over 9 years (250 working days/year). Learn about impossible service volumes →
This provider's $20.3M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 63 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 180265% from 2015 to 2023.
62% of their billing comes from a single procedure code (J0178 — Injection, aflibercept, 1 mg).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 5503% 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 |
|---|---|---|---|---|---|---|---|
| 2015 | $147.79 | $28.97 | 5.10x | $118.82 | $2.5K | 86 | 2 |
| 2016 | $155.51 | $30.47 | 5.10x | $125.04 | $7.2K | 236 | 6 |
| 2017 | $666.66 | $203.20 | 3.28x | $463.46 | $402.9K | 2.0K | 15 |
| 2018 | $605.28 | $182.24 | 3.32x | $423.04 | $2.6M | 14.1K | 18 |
| 2019 | $632.50 | $184.91 | 3.42x | $447.59 | $2.8M | 15.3K | 21 |
| 2020 | $697.40 | $204.89 | 3.40x | $492.51 | $3.1M | 14.9K | 18 |
| 2021 | $766.98 | $223.29 | 3.43x | $543.69 | $3.3M | 14.8K | 20 |
| 2022 | $581.86 | $164.41 | 3.54x | $417.45 | $3.6M | 22.2K | 21 |
| 2023 | $267.63 | $76.19 | 3.51x | $191.44 | $4.5M | 59.0K | 25 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 17.2K | $12.6M | $729.26 | 3.08x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 53.8K | $1.6M | $29.10 | 2.85x |
| J2778 | Injection, ranibizumab, 0.1 mg | 5.0K | $1.3M | $263.86 | 1.89x |
| 67028 | Injection of drug into eye | 11.4K | $1.0M | $89.98 | 12.46x |
| 92134 | Imaging of retina | 19.8K | $614.9K | $31.10 | 3.22x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 2.1K | $510.6K | $248.85 | 3.01x |
| 92014 | Established patient complete exam of visual system | 4.2K | $381.5K | $90.31 | 2.22x |
| J3490 | Unclassified drugs | 176 | $351.5K | $2.0K | 3.27x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 6.4K | $346.1K | $53.83 | 2.06x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 1.8K | $280.3K | $154.00 | 2.76x |
| 92012 | Established patient problem focused exam of visual system | 4.3K | $274.0K | $63.98 | 2.24x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 155 | $138.8K | $895.41 | 6.37x |
| 92004 | New patient complete exam of visual system | 1.2K | $132.4K | $109.88 | 2.50x |
| J9035 | Injection, bevacizumab, 10 mg | 2.2K | $128.3K | $59.38 | 2.53x |
| J3590 | Unclassified biologics | 69 | $116.7K | $1.7K | 3.26x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 902 | $108.3K | $120.09 | 2.77x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 1.1K | $93.7K | $86.24 | 1.97x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 608 | $72.3K | $118.95 | 2.35x |
| 67113 | Complex repair of detached retina and drainage of eye fluid between lens and retina | 61 | $59.3K | $971.79 | 6.69x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina, with removal of vitreous fluid | 51 | $47.3K | $927.33 | 6.47x |
This provider submits charges 3.45 times higher than what Medicare actually pays.
A markup ratio of 3.45x means for every $100 Medicare pays, this provider initially charges $345. 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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