⚠️ This provider averages 205 services per working day — physically unusual for an individual practitioner
Based on 511.4K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $47.0M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 205 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 156% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 81% in 2018
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 | $298.68 | $76.93 | 3.88x | $221.75 | $2.9M | 37.2K | 23 |
| 2015 | $324.45 | $84.94 | 3.82x | $239.51 | $3.0M | 35.4K | 23 |
| 2016 | $333.77 | $87.87 | 3.80x | $245.90 | $3.2M | 36.6K | 21 |
| 2017 | $350.54 | $92.32 | 3.80x | $258.22 | $2.9M | 31.9K | 21 |
| 2018 | $389.41 | $131.26 | 2.97x | $258.15 | $5.3M | 40.7K | 25 |
| 2019 | $400.51 | $138.28 | 2.90x | $262.23 | $6.1M | 44.3K | 22 |
| 2020 | $455.86 | $165.61 | 2.75x | $290.25 | $5.1M | 30.9K | 19 |
| 2021 | $441.23 | $158.71 | 2.78x | $282.52 | $5.1M | 32.1K | 21 |
| 2022 | $252.40 | $94.28 | 2.68x | $158.12 | $6.0M | 63.7K | 23 |
| 2023 | $142.25 | $46.23 | 3.08x | $96.02 | $7.3M | 158.5K | 27 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2778 | Injection, ranibizumab, 0.1 mg | 47.2K | $12.5M | $264.19 | 1.89x |
| J0178 | Injection, aflibercept, 1 mg | 10.3K | $7.8M | $750.23 | 2.00x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 169.1K | $4.9M | $29.24 | 2.06x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 42.4K | $3.2M | $76.14 | 4.14x |
| 67028 | Injection of drug into eye | 32.6K | $2.6M | $78.45 | 8.56x |
| 92240 | Exam of blood vessels between the white part of eye and retina using a special camera after injection of a dye | 13.8K | $2.3M | $163.34 | 3.52x |
| J3590 | Unclassified biologics | 1.3K | $2.2M | $1.7K | 1.89x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 24.9K | $2.0M | $81.18 | 3.46x |
| 92014 | Established patient complete exam of visual system | 23.4K | $2.0M | $85.54 | 3.51x |
| J3490 | Unclassified drugs | 824 | $1.4M | $1.7K | 4.32x |
| 92250 | Photography of the retina | 26.3K | $1.1M | $41.67 | 4.44x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 56.8K | $1.1M | $18.88 | 7.94x |
| 92242 | Exam of retinal blood vessels and blood vessels between the white part of eye and retina using a special camera after injection of a dye | 4.4K | $756.3K | $172.36 | 3.48x |
| J9035 | Injection, bevacizumab, 10 mg | 10.9K | $584.2K | $53.45 | 1.56x |
| 92134 | Imaging of retina | 19.1K | $568.7K | $29.73 | 5.38x |
| 67210 | Destruction of growth of retina using a laser | 1.1K | $408.0K | $383.80 | 4.23x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 418 | $385.8K | $922.94 | 4.98x |
| 92201 | Extended exam of the back part of the eye with retinal drawing | 9.9K | $189.5K | $19.09 | 3.93x |
| 67113 | Complex repair of detached retina and drainage of eye fluid between lens and retina | 161 | $172.5K | $1.1K | 4.06x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.3K | $145.3K | $109.96 | 3.64x |
This provider submits charges 3.11 times higher than what Medicare actually pays.
A markup ratio of 3.11x means for every $100 Medicare pays, this provider initially charges $311. 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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