This provider's $9.2M in total Medicare payments ranks in the 98th percentile of Ophthalmology providers nationally.
Their average markup ratio of 5.78x is significantly above the specialty median of 2.9x.
Medicare payments to this provider grew 409839% from 2017 to 2023.
66% of their billing comes from a single procedure code (J2778 — Injection, ranibizumab, 0.1 mg).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 16271% in 2021
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 |
|---|---|---|---|---|---|---|---|
| 2017 | $183.00 | $57.93 | 3.16x | $125.07 | $926.85 | 16 | 1 |
| 2018 | $125.80 | $37.94 | 3.32x | $87.86 | $2.4K | 64 | 2 |
| 2019 | $189.09 | $42.47 | 4.45x | $146.62 | $23.8K | 560 | 5 |
| 2020 | $197.15 | $37.70 | 5.23x | $159.45 | $12.2K | 324 | 5 |
| 2021 | $985.03 | $194.42 | 5.07x | $790.61 | $2.0M | 10.3K | 10 |
| 2022 | $980.35 | $172.94 | 5.67x | $807.41 | $3.4M | 19.6K | 14 |
| 2023 | $813.06 | $129.69 | 6.27x | $683.37 | $3.8M | 29.3K | 18 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2778 | Injection, ranibizumab, 0.1 mg | 29.4K | $6.1M | $208.20 | 5.85x |
| J0178 | Injection, aflibercept, 1 mg | 1.3K | $910.9K | $706.71 | 4.16x |
| 67028 | Injection of drug into eye | 7.5K | $650.7K | $86.67 | 8.11x |
| 92014 | Established patient complete exam of visual system | 5.3K | $491.9K | $92.09 | 4.32x |
| 92134 | Imaging of retina | 7.1K | $211.2K | $29.75 | 8.25x |
| J3490 | Unclassified drugs | 94 | $170.1K | $1.8K | 3.95x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 5.7K | $165.2K | $28.97 | 4.04x |
| 92004 | New patient complete exam of visual system | 820 | $88.5K | $107.96 | 4.04x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 570 | $68.6K | $120.36 | 3.89x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 629 | $61.7K | $98.04 | 7.84x |
| 67228 | Destruction of leaking blood vessels of retina using laser | 234 | $60.0K | $256.23 | 12.88x |
| 67041 | Removal of membrane of retina | 62 | $54.2K | $874.93 | 4.46x |
| 67110 | Repair of detached retina by injection of air or gas | 51 | $34.6K | $677.76 | 3.98x |
| 67040 | Destruction of eye fluid (vitreous) between lens and retina and all of retina using a laser | 35 | $25.3K | $722.30 | 5.81x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 161 | $23.2K | $144.15 | 4.19x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 97 | $21.9K | $225.81 | 7.16x |
| 92250 | Photography of the retina | 641 | $18.8K | $29.27 | 15.62x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 283 | $11.7K | $41.31 | 3.58x |
| 67105 | Repair of detached retina using a laser | 52 | $10.5K | $202.25 | 10.38x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 12 | $10.3K | $859.44 | 5.18x |
This provider submits charges 5.78 times higher than what Medicare actually pays.
A markup ratio of 5.78x means for every $100 Medicare pays, this provider initially charges $578. 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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