This provider averages 56 services per working day
Based on 139.9K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $13.0M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 56 services per working day raises questions about billing patterns.
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 | $320.90 | $244.38 | 1.31x | $76.52 | $1.2M | 14.0K | 6.5K |
| 2015 | $333.13 | $244.17 | 1.36x | $88.96 | $1.4M | 13.8K | 6.2K |
| 2016 | $241.98 | $176.63 | 1.37x | $65.35 | $1.4M | 14.5K | 5.9K |
| 2017 | $284.37 | $213.21 | 1.33x | $71.16 | $1.5M | 15.2K | 6.1K |
| 2018 | $252.19 | $173.93 | 1.45x | $78.26 | $1.5M | 16.9K | 6.6K |
| 2019 | $282.70 | $209.36 | 1.35x | $73.34 | $1.4M | 15.2K | 6.6K |
| 2020 | $251.43 | $174.12 | 1.44x | $77.31 | $1.2M | 12.7K | 5.3K |
| 2021 | $245.38 | $169.16 | 1.45x | $76.22 | $1.3M | 12.6K | 5.4K |
| 2022 | $239.97 | $154.90 | 1.55x | $85.07 | $1.2M | 12.6K | 5.6K |
| 2023 | $254.92 | $160.20 | 1.59x | $94.72 | $1.1M | 12.3K | 5.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 6.5K | $4.8M | $748.04 | 1.30x |
| 67028 | Injection of drug into eye | 23.6K | $1.9M | $79.94 | 1.43x |
| 92134 | Diagnostic imaging of retina | 38.1K | $1.2M | $30.49 | 1.46x |
| J7999 | Compounded drug, not otherwise classified | 12.0K | $798.8K | $66.32 | 3.06x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 9.4K | $795.6K | $84.86 | 1.56x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 12.3K | $768.5K | $62.57 | 1.46x |
| J2778 | Injection, ranibizumab, 0.1 mg | 1.9K | $538.7K | $281.28 | 1.32x |
| 67042 | Removal of membrane from the retina, pars plana approach | 565 | $521.6K | $923.14 | 1.36x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 3.2K | $374.8K | $115.51 | 1.52x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 3.4K | $266.4K | $78.75 | 1.40x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.7K | $230.1K | $62.56 | 1.48x |
| 92250 | Photography of the retina | 2.8K | $129.0K | $45.52 | 1.55x |
| J3590 | Unclassified biologics | 2.0K | $103.6K | $52.45 | 1.28x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 5.4K | $103.0K | $19.07 | 1.36x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.3K | $96.4K | $73.63 | 1.55x |
| 92201 | Extended examination of eye with drawing of retina | 5.1K | $90.5K | $17.87 | 1.56x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 3.4K | $73.0K | $21.15 | 1.34x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 54 | $67.7K | $1.3K | 1.28x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 255 | $37.6K | $147.61 | 1.51x |
| 67145 | Preventive retinal detachment treatment by heat or laser, 1 or more sessions | 90 | $37.4K | $415.32 | 1.36x |
This provider submits charges 1.5 times higher than what Medicare actually pays.
A markup ratio of 1.5x means for every $100 Medicare pays, this provider initially charges $150. This is lower 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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