This provider averages 59 services per working day
Based on 146.9K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $14.7M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 59 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 51% 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 | $394.95 | $277.74 | 1.42x | $117.21 | $980.9K | 12.3K | 5.0K |
| 2015 | $309.35 | $223.79 | 1.38x | $85.56 | $1.1M | 13.1K | 5.2K |
| 2016 | $366.88 | $249.73 | 1.47x | $117.15 | $1.4M | 14.5K | 5.4K |
| 2017 | $354.00 | $256.56 | 1.38x | $97.44 | $1.6M | 15.9K | 5.6K |
| 2018 | $358.89 | $237.93 | 1.51x | $120.96 | $1.6M | 16.4K | 6.0K |
| 2019 | $376.07 | $262.49 | 1.43x | $113.58 | $1.7M | 15.5K | 6.2K |
| 2020 | $386.23 | $259.16 | 1.49x | $127.07 | $1.6M | 14.3K | 5.5K |
| 2021 | $381.77 | $256.71 | 1.49x | $125.06 | $1.7M | 14.8K | 5.7K |
| 2022 | $386.96 | $247.12 | 1.57x | $139.84 | $1.5M | 14.7K | 6.1K |
| 2023 | $377.11 | $247.66 | 1.52x | $129.45 | $1.5M | 15.2K | 6.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 6.8K | $5.1M | $744.68 | 1.31x |
| 67028 | Injection of drug into eye | 25.9K | $2.2M | $85.68 | 1.53x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 28.6K | $1.8M | $61.76 | 1.50x |
| 92134 | Diagnostic imaging of retina | 41.2K | $1.2M | $30.15 | 1.48x |
| J7999 | Compounded drug, not otherwise classified | 13.9K | $935.5K | $67.23 | 3.01x |
| 67042 | Removal of membrane from the retina, pars plana approach | 671 | $614.4K | $915.70 | 1.37x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 5.7K | $488.6K | $85.01 | 1.56x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 407 | $420.7K | $1.0K | 1.50x |
| 67041 | Removal of membrane from the retina | 461 | $402.7K | $873.48 | 1.42x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 3.2K | $371.6K | $115.54 | 1.52x |
| J2778 | Injection, ranibizumab, 0.1 mg | 991 | $259.0K | $261.34 | 1.39x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 2.7K | $213.1K | $77.64 | 1.41x |
| J3590 | Unclassified biologics | 2.4K | $128.5K | $52.49 | 1.28x |
| 92250 | Photography of the retina | 2.4K | $105.1K | $44.16 | 1.55x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 582 | $92.0K | $158.01 | 1.31x |
| 67145 | Preventive retinal detachment treatment by heat or laser, 1 or more sessions | 160 | $65.3K | $408.32 | 1.37x |
| 92201 | Extended examination of eye with drawing of retina | 2.3K | $41.8K | $17.97 | 1.52x |
| 65800 | Aspiration of eye fluid | 412 | $37.7K | $91.46 | 1.48x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 1.7K | $35.3K | $21.31 | 1.34x |
| J9035 | Injection, bevacizumab, 10 mg | 572 | $23.4K | $40.87 | 3.11x |
This provider submits charges 1.53 times higher than what Medicare actually pays.
A markup ratio of 1.53x means for every $100 Medicare pays, this provider initially charges $153. 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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