This provider's $11.8M in total Medicare payments ranks in the 98th percentile of Ophthalmology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $334.02 | $125.81 | 2.65x | $208.21 | $519.9K | 8.5K | 3.4K |
| 2015 | $387.69 | $155.53 | 2.49x | $232.16 | $634.2K | 9.2K | 3.7K |
| 2016 | $292.14 | $109.42 | 2.67x | $182.72 | $814.9K | 9.8K | 3.8K |
| 2017 | $372.00 | $114.76 | 3.24x | $257.24 | $1.0M | 10.9K | 4.4K |
| 2018 | $343.36 | $107.90 | 3.18x | $235.46 | $1.3M | 11.5K | 4.9K |
| 2019 | $407.29 | $115.07 | 3.54x | $292.22 | $1.7M | 11.6K | 4.8K |
| 2020 | $341.30 | $105.93 | 3.22x | $235.37 | $1.6M | 9.5K | 3.9K |
| 2021 | $453.71 | $127.39 | 3.56x | $326.32 | $1.8M | 10.4K | 4.0K |
| 2022 | $455.33 | $124.45 | 3.66x | $330.88 | $1.8M | 11.0K | 4.8K |
| 2023 | $504.45 | $140.15 | 3.60x | $364.30 | $564.9K | 8.5K | 4.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 8.9K | $6.5M | $738.00 | 2.85x |
| 67028 | Injection of drug into eye | 17.1K | $1.4M | $80.63 | 3.30x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 11.6K | $1.0M | $88.26 | 2.24x |
| 92134 | Diagnostic imaging of retina | 28.3K | $864.1K | $30.54 | 4.91x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 7.0K | $543.0K | $77.56 | 2.58x |
| J9035 | Injection, bevacizumab, 10 mg | 6.9K | $385.4K | $55.53 | 2.78x |
| 92250 | Photography of the retina | 7.5K | $310.9K | $41.39 | 3.42x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 2.5K | $257.5K | $104.20 | 2.27x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 281 | $111.1K | $395.50 | 3.79x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 1.6K | $103.2K | $64.00 | 2.38x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 600 | $93.8K | $156.41 | 2.75x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 225 | $64.1K | $284.75 | 5.27x |
| 92201 | Extended examination of eye with drawing of retina | 1.2K | $21.6K | $18.15 | 5.24x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 968 | $18.4K | $19.03 | 3.94x |
| 76512 | Ultrasound of eye disease, growth, or structure | 296 | $16.5K | $55.76 | 3.82x |
| 92240 | Examination of eye using an endoscope | 61 | $11.4K | $187.11 | 2.14x |
| 92020 | Examination of cornea and iris using lens device and slit lamp | 172 | $3.5K | $20.18 | 3.72x |
| 67515 | Injection of medication or substance into membrane covering eyeball | 36 | $2.4K | $66.61 | 3.75x |
| 92285 | Photography of content of eyes | 123 | $2.0K | $16.12 | 6.20x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 70 | $1.5K | $20.88 | 4.60x |
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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