This provider's $7.6M in total Medicare payments ranks in the 97th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 328% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 99% in 2015
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 | $957.50 | $225.19 | 4.25x | $732.31 | $203.9K | 2.7K | 1.3K |
| 2015 | $1.2K | $286.26 | 4.11x | $890.28 | $405.8K | 4.4K | 2.1K |
| 2016 | $1.3K | $259.08 | 4.85x | $998.65 | $783.3K | 8.4K | 4.6K |
| 2017 | $1.6K | $292.13 | 5.39x | $1.3K | $989.1K | 11.0K | 4.8K |
| 2018 | $1.2K | $244.34 | 4.98x | $971.91 | $778.1K | 9.4K | 3.8K |
| 2019 | $1.2K | $246.80 | 4.82x | $943.87 | $921.7K | 9.6K | 3.7K |
| 2020 | $1.2K | $239.41 | 4.90x | $933.48 | $854.8K | 8.2K | 3.3K |
| 2021 | $1.4K | $273.57 | 5.02x | $1.1K | $956.1K | 9.3K | 3.5K |
| 2022 | $1.5K | $278.33 | 5.48x | $1.2K | $812.4K | 8.7K | 3.9K |
| 2023 | $518.72 | $141.01 | 3.68x | $377.71 | $873.6K | 9.6K | 3.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 2.5K | $1.8M | $732.10 | 2.73x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 18.3K | $1.5M | $84.29 | 3.57x |
| 67028 | Injection of drug into eye | 12.2K | $929.9K | $76.32 | 6.71x |
| 92134 | Diagnostic imaging of retina | 20.8K | $609.8K | $29.37 | 5.76x |
| J9035 | Injection, bevacizumab, 10 mg | 6.5K | $375.1K | $57.39 | 3.05x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 4.1K | $299.8K | $72.34 | 4.47x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 3.2K | $287.8K | $89.73 | 3.49x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 3.2K | $195.8K | $61.17 | 3.28x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 843 | $183.6K | $217.81 | 3.69x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 559 | $162.5K | $290.61 | 7.16x |
| 92250 | Photography of the retina | 3.2K | $141.8K | $43.76 | 4.11x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.3K | $138.5K | $110.31 | 3.72x |
| 67041 | Removal of membrane from the retina | 138 | $123.3K | $893.59 | 6.16x |
| 67042 | Removal of membrane from the retina, pars plana approach | 122 | $105.1K | $861.19 | 6.39x |
| 67145 | Preventive retinal detachment treatment by heat or laser, 1 or more sessions | 288 | $92.7K | $321.96 | 3.84x |
| J2778 | Injection, ranibizumab, 0.1 mg | 399 | $90.1K | $225.85 | 3.54x |
| 92242 | Imaging of blood vessels in back of eye using fluorescein and indocyanine-green dye | 426 | $70.8K | $166.30 | 3.28x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 718 | $68.8K | $95.80 | 3.77x |
| 92240 | Examination of eye using an endoscope | 340 | $59.9K | $176.16 | 3.35x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 155 | $58.7K | $378.59 | 3.30x |
This provider submits charges 4.13 times higher than what Medicare actually pays.
A markup ratio of 4.13x means for every $100 Medicare pays, this provider initially charges $413. 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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