This provider's $7.1M in total Medicare payments ranks in the 97th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 81% 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 | $1.1K | $417.46 | 2.56x | $651.92 | $520.4K | 5.7K | 2.6K |
| 2015 | $549.15 | $187.82 | 2.92x | $361.33 | $434.2K | 5.6K | 2.5K |
| 2016 | $933.93 | $303.23 | 3.08x | $630.70 | $525.9K | 5.7K | 2.5K |
| 2017 | $1.1K | $369.69 | 3.09x | $771.61 | $569.4K | 5.8K | 2.4K |
| 2018 | $1.4K | $418.05 | 3.28x | $952.75 | $680.9K | 6.1K | 2.6K |
| 2019 | $1.2K | $414.58 | 2.94x | $803.38 | $757.8K | 6.6K | 2.7K |
| 2020 | $1.2K | $361.71 | 3.25x | $814.50 | $824.0K | 7.0K | 2.9K |
| 2021 | $1.0K | $305.33 | 3.32x | $707.60 | $921.8K | 7.4K | 3.2K |
| 2022 | $1.0K | $308.98 | 3.37x | $732.21 | $949.5K | 7.6K | 2.9K |
| 2023 | $1.4K | $369.04 | 3.68x | $989.53 | $943.0K | 7.3K | 3.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 67028 | Injection of drug into eye | 11.6K | $1.0M | $89.86 | 7.11x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 8.7K | $759.9K | $87.60 | 1.97x |
| J0178 | Injection, aflibercept, 1 mg | 954 | $700.6K | $734.43 | 2.61x |
| 92134 | Diagnostic imaging of retina | 19.4K | $591.3K | $30.45 | 3.23x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 810 | $538.4K | $664.73 | 3.85x |
| J7999 | Compounded drug, not otherwise classified | 6.4K | $424.9K | $65.92 | 2.58x |
| 92242 | Imaging of blood vessels in back of eye using fluorescein and indocyanine-green dye | 2.3K | $422.7K | $185.90 | 2.30x |
| 67041 | Removal of membrane from the retina | 464 | $417.5K | $899.71 | 2.42x |
| 99214 | Established patient outpatient visit, total time 30-39 minutes | 3.3K | $302.8K | $91.48 | 2.95x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 2.7K | $210.3K | $79.24 | 2.51x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 186 | $175.0K | $940.71 | 2.97x |
| 92240 | Examination of eye using an endoscope | 883 | $169.5K | $191.94 | 1.69x |
| 67042 | Removal of membrane from the retina, pars plana approach | 177 | $159.7K | $902.28 | 2.64x |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 610 | $152.8K | $250.51 | 2.52x |
| 67039 | Laser destruction of eye fluid (vitreous) between the lens and retina | 198 | $149.6K | $755.72 | 4.15x |
| J2778 | Injection, ranibizumab, 0.1 mg | 479 | $127.9K | $266.99 | 2.40x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.0K | $119.8K | $119.01 | 2.92x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 782 | $84.2K | $107.66 | 2.01x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 355 | $77.1K | $217.12 | 3.32x |
| J9035 | Injection, bevacizumab, 10 mg | 1.2K | $65.1K | $52.55 | 1.52x |
This provider submits charges 3.41 times higher than what Medicare actually pays.
A markup ratio of 3.41x means for every $100 Medicare pays, this provider initially charges $341. 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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