This provider averages 51 services per working day
Based on 127.4K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $13.6M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 51 services per working day raises questions about billing patterns.
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 | $1.2K | $301.79 | 3.98x | $897.86 | $1.4M | 14.2K | 7.4K |
| 2015 | $1.2K | $290.93 | 4.16x | $919.87 | $1.6M | 14.9K | 7.8K |
| 2016 | $1.3K | $258.62 | 5.11x | $1.1K | $1.7M | 15.9K | 8.6K |
| 2017 | $1.5K | $286.86 | 5.22x | $1.2K | $1.7M | 15.7K | 8.1K |
| 2018 | $1.4K | $270.83 | 5.08x | $1.1K | $1.4M | 13.2K | 6.5K |
| 2019 | $1.1K | $236.12 | 4.75x | $886.40 | $1.4M | 12.7K | 6.0K |
| 2020 | $1.0K | $211.09 | 4.84x | $810.11 | $1.0M | 9.7K | 5.0K |
| 2021 | $1.2K | $234.73 | 4.92x | $919.14 | $1.1M | 10.1K | 4.6K |
| 2022 | $1.3K | $248.10 | 5.43x | $1.1K | $1.0M | 9.3K | 4.8K |
| 2023 | $1.3K | $233.32 | 5.65x | $1.1K | $1.2M | 11.8K | 5.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 5.4K | $4.0M | $744.26 | 2.69x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 34.8K | $2.9M | $82.99 | 3.62x |
| 67028 | Injection of drug into eye | 14.0K | $1.1M | $75.13 | 6.72x |
| 92134 | Diagnostic imaging of retina | 32.9K | $975.7K | $29.63 | 5.88x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 7.7K | $551.6K | $71.51 | 4.53x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 1.1K | $421.4K | $381.36 | 3.51x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 1.3K | $415.5K | $326.42 | 6.31x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 3.7K | $329.8K | $89.13 | 3.53x |
| 67041 | Removal of membrane from the retina | 340 | $304.4K | $895.33 | 6.14x |
| J9035 | Injection, bevacizumab, 10 mg | 5.3K | $290.8K | $55.17 | 3.17x |
| 92250 | Photography of the retina | 6.5K | $288.2K | $44.57 | 4.03x |
| 67042 | Removal of membrane from the retina, pars plana approach | 277 | $249.2K | $899.69 | 6.11x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 4.1K | $247.8K | $60.03 | 3.34x |
| 92242 | Imaging of blood vessels in back of eye using fluorescein and indocyanine-green dye | 1.2K | $219.4K | $177.53 | 3.19x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 927 | $202.2K | $218.15 | 3.71x |
| 92240 | Examination of eye using an endoscope | 1.1K | $195.5K | $174.42 | 3.38x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.5K | $165.7K | $111.65 | 3.67x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 1.7K | $165.1K | $96.81 | 3.72x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 515 | $128.7K | $249.96 | 2.80x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 79 | $86.8K | $1.1K | 5.46x |
This provider submits charges 3.98 times higher than what Medicare actually pays.
A markup ratio of 3.98x means for every $100 Medicare pays, this provider initially charges $398. 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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