This provider's $11.5M in total Medicare payments ranks in the 98th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 97% from 2014 to 2023.
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 | $805.98 | $275.76 | 2.92x | $530.22 | $518.4K | 6.1K | 2.7K |
| 2015 | $801.75 | $247.83 | 3.24x | $553.92 | $739.6K | 7.7K | 3.4K |
| 2016 | $832.99 | $255.24 | 3.26x | $577.75 | $937.0K | 9.7K | 3.9K |
| 2017 | $935.70 | $286.00 | 3.27x | $649.70 | $1.2M | 11.9K | 4.9K |
| 2018 | $966.57 | $284.71 | 3.39x | $681.86 | $1.5M | 13.5K | 5.0K |
| 2019 | $1.2K | $335.40 | 3.49x | $835.82 | $1.5M | 13.3K | 5.1K |
| 2020 | $1.2K | $325.73 | 3.57x | $835.83 | $1.4M | 11.6K | 4.3K |
| 2021 | $645.15 | $209.75 | 3.08x | $435.40 | $1.4M | 12.1K | 4.4K |
| 2022 | $622.33 | $209.01 | 2.98x | $413.32 | $1.2M | 10.3K | 3.9K |
| 2023 | $1.1K | $344.37 | 3.34x | $805.58 | $1.0M | 10.4K | 4.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 6.2K | $4.6M | $743.72 | 1.60x |
| 67028 | Injection of drug into eye | 23.6K | $2.0M | $86.40 | 3.99x |
| 92134 | Diagnostic imaging of retina | 34.6K | $1.0M | $30.12 | 3.65x |
| J9035 | Injection, bevacizumab, 10 mg | 16.9K | $957.0K | $56.54 | 1.85x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 4.7K | $410.1K | $86.62 | 3.30x |
| 67041 | Removal of membrane from the retina | 343 | $312.5K | $911.06 | 3.47x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.3K | $300.5K | $56.99 | 3.02x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 2.9K | $293.5K | $101.95 | 2.35x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.4K | $284.1K | $119.45 | 3.27x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 3.7K | $237.5K | $64.33 | 3.06x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.9K | $154.4K | $79.50 | 3.18x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 247 | $148.6K | $601.77 | 3.77x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 147 | $137.7K | $936.71 | 3.96x |
| 67042 | Removal of membrane from the retina, pars plana approach | 136 | $125.0K | $919.38 | 3.93x |
| 67145 | Preventive retinal detachment treatment by heat or laser, 1 or more sessions | 247 | $94.4K | $382.04 | 3.12x |
| 92250 | Photography of the retina | 1.7K | $72.7K | $41.55 | 4.35x |
| J3490 | Unclassified drugs | 34 | $50.9K | $1.5K | 2.37x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 139 | $35.9K | $258.58 | 4.64x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 212 | $33.5K | $157.93 | 1.58x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 34 | $32.8K | $963.72 | 4.32x |
This provider submits charges 2.64 times higher than what Medicare actually pays.
A markup ratio of 2.64x means for every $100 Medicare pays, this provider initially charges $264. 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 AZ for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Derek Kunimoto, MD | Mesa, AZ | $68.3M | ✓ Clear |
| David Goldenberg, MD | Phoenix, AZ | $50.8M | ✓ Clear |
| Sachin Mehta, M.D. | Phoenix, AZ | $43.3M | ✓ Clear |
| Edward Quinlan, M.D. | Phoenix, AZ | $40.1M | ✓ 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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