This provider averages 71 services per working day
Based on 123.7K total services over 7 years (250 working days/year). Learn about impossible service volumes →
This provider's $16.2M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 71 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 1270% from 2017 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 563% 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 |
|---|---|---|---|---|---|---|---|
| 2017 | $318.30 | $103.79 | 3.07x | $214.51 | $269.2K | 2.6K | 9 |
| 2018 | $396.71 | $148.14 | 2.68x | $248.57 | $1.8M | 12.0K | 14 |
| 2019 | $467.81 | $180.90 | 2.59x | $286.91 | $2.5M | 14.0K | 14 |
| 2020 | $484.13 | $181.79 | 2.66x | $302.34 | $2.7M | 14.6K | 12 |
| 2021 | $572.31 | $176.30 | 3.25x | $396.01 | $2.7M | 15.1K | 15 |
| 2022 | $572.35 | $171.21 | 3.34x | $401.14 | $2.6M | 15.2K | 17 |
| 2023 | $258.19 | $73.51 | 3.51x | $184.68 | $3.7M | 50.2K | 20 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 12.1K | $8.8M | $732.03 | 2.51x |
| 67028 | Injection of drug into eye | 15.6K | $1.4M | $90.94 | 6.53x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 35.6K | $1.0M | $29.02 | 3.28x |
| J2778 | Injection, ranibizumab, 0.1 mg | 4.0K | $990.3K | $249.44 | 2.76x |
| J7999 | Compounded drug, not otherwise classified | 11.3K | $780.2K | $69.03 | 2.95x |
| 92014 | Established patient complete exam of visual system | 8.4K | $738.7K | $88.19 | 2.46x |
| 92134 | Imaging of retina | 23.1K | $675.4K | $29.23 | 3.42x |
| Q5124 | Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg | 1.5K | $258.2K | $169.89 | 4.41x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 2.8K | $250.4K | $90.97 | 2.97x |
| 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 | 1.3K | $234.9K | $187.76 | 2.36x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 2.6K | $219.1K | $83.82 | 2.65x |
| J3490 | Unclassified drugs | 93 | $164.5K | $1.8K | 4.52x |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 685 | $145.7K | $212.76 | 3.39x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 1.1K | $130.3K | $118.98 | 3.12x |
| 92004 | New patient complete exam of visual system | 1.1K | $119.7K | $109.86 | 2.42x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 744 | $84.5K | $113.54 | 2.51x |
| 67210 | Destruction of growth of retina using a laser | 195 | $78.1K | $400.67 | 2.92x |
| 67145 | Photocoagulation treatment to prevent detachment of retina | 44 | $12.1K | $274.38 | 4.35x |
| 92250 | Photography of the retina | 331 | $9.8K | $29.48 | 3.91x |
| 76512 | 2d ultrasound scan of eye tissue and structures | 177 | $7.4K | $41.99 | 3.92x |
This provider submits charges 3.06 times higher than what Medicare actually pays.
A markup ratio of 3.06x means for every $100 Medicare pays, this provider initially charges $306. 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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