This provider's $29.9M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 7373% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1292% 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 | $221.43 | $113.51 | 1.95x | $107.92 | $49.9K | 440 | 8 |
| 2015 | $569.27 | $252.46 | 2.25x | $316.81 | $695.3K | 2.8K | 13 |
| 2016 | $556.35 | $244.12 | 2.28x | $312.23 | $2.7M | 11.0K | 12 |
| 2017 | $529.99 | $227.82 | 2.33x | $302.17 | $2.9M | 12.8K | 14 |
| 2018 | $542.43 | $237.25 | 2.29x | $305.18 | $3.8M | 15.8K | 13 |
| 2019 | $543.34 | $227.80 | 2.39x | $315.54 | $4.4M | 19.1K | 15 |
| 2020 | $568.45 | $233.61 | 2.43x | $334.84 | $4.3M | 18.2K | 10 |
| 2021 | $607.23 | $245.21 | 2.48x | $362.02 | $3.8M | 15.5K | 12 |
| 2022 | $754.52 | $302.97 | 2.49x | $451.55 | $3.6M | 12.0K | 12 |
| 2023 | $1.0K | $263.20 | 3.97x | $781.50 | $3.7M | 14.2K | 16 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2778 | Injection, ranibizumab, 0.1 mg | 50.3K | $13.9M | $275.77 | 2.17x |
| J0178 | Injection, aflibercept, 1 mg | 16.1K | $11.7M | $728.82 | 2.42x |
| 67028 | Injection of drug into eye | 15.6K | $1.4M | $90.12 | 5.70x |
| 92014 | Established patient complete exam of visual system | 9.8K | $866.9K | $88.07 | 2.70x |
| 92134 | Imaging of retina | 19.5K | $583.1K | $29.96 | 4.85x |
| J3590 | Unclassified biologics | 160 | $316.7K | $2.0K | 3.79x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 1.1K | $251.0K | $218.22 | 3.86x |
| J3490 | Unclassified drugs | 96 | $169.8K | $1.8K | 3.91x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 1.2K | $140.8K | $120.36 | 3.75x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 862 | $100.4K | $116.44 | 2.67x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 1.0K | $78.7K | $75.20 | 3.88x |
| 67042 | Removal of membrane from the retina, pars plana approach with removal of internal limiting membrane of retina | 119 | $73.2K | $614.71 | 5.32x |
| 92012 | Established patient problem focused exam of visual system | 1.2K | $71.1K | $59.52 | 2.02x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 2.1K | $61.2K | $29.16 | 3.91x |
| 92250 | Photography of the retina | 1.0K | $38.1K | $36.94 | 4.29x |
| 92004 | New patient complete exam of visual system | 334 | $34.9K | $104.36 | 2.82x |
| J9035 | Injection, bevacizumab, 10 mg | 586 | $33.8K | $57.66 | 5.06x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 67 | $31.0K | $462.32 | 5.95x |
| J7999 | Compounded drug, not otherwise classified | 190 | $12.5K | $65.92 | 4.67x |
| 66986 | Exchange of lens prosthesis | 12 | $8.7K | $727.81 | 3.30x |
This provider submits charges 2.58 times higher than what Medicare actually pays.
A markup ratio of 2.58x means for every $100 Medicare pays, this provider initially charges $258. 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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