This provider's $7.9M in total Medicare payments ranks in the 98th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 114% 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 | $154.08 | $110.26 | 1.40x | $43.82 | $510.0K | 6.5K | 3.4K |
| 2015 | $140.32 | $94.88 | 1.48x | $45.44 | $587.5K | 6.6K | 3.1K |
| 2016 | $148.41 | $100.76 | 1.47x | $47.65 | $639.5K | 6.8K | 3.1K |
| 2017 | $163.53 | $114.76 | 1.42x | $48.77 | $712.5K | 7.5K | 3.3K |
| 2018 | $175.97 | $116.89 | 1.51x | $59.08 | $749.1K | 8.1K | 3.5K |
| 2019 | $172.06 | $115.32 | 1.49x | $56.74 | $948.1K | 9.9K | 4.4K |
| 2020 | $177.76 | $119.37 | 1.49x | $58.39 | $779.5K | 9.0K | 3.6K |
| 2021 | $185.92 | $126.43 | 1.47x | $59.49 | $921.9K | 9.4K | 3.8K |
| 2022 | $177.12 | $110.40 | 1.60x | $66.72 | $976.0K | 10.5K | 4.3K |
| 2023 | $171.42 | $108.88 | 1.57x | $62.54 | $1.1M | 11.5K | 4.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 3.6K | $2.7M | $742.98 | 1.32x |
| 67028 | Injection of drug into eye | 16.1K | $1.4M | $88.98 | 1.55x |
| 92134 | Diagnostic imaging of retina | 22.8K | $689.1K | $30.17 | 1.48x |
| J7999 | Compounded drug, not otherwise classified | 9.2K | $631.5K | $68.70 | 3.05x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 5.5K | $476.2K | $87.34 | 1.53x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 5.0K | $429.6K | $85.26 | 1.54x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 5.2K | $319.2K | $61.77 | 1.47x |
| J2778 | Injection, ranibizumab, 0.1 mg | 1.1K | $302.5K | $263.04 | 1.46x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.2K | $203.5K | $63.01 | 1.46x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.7K | $200.8K | $114.96 | 1.54x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 1.1K | $87.9K | $78.74 | 1.43x |
| J3590 | Unclassified biologics | 1.2K | $61.8K | $52.41 | 1.28x |
| 92250 | Photography of the retina | 1.4K | $57.6K | $42.43 | 1.57x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 303 | $46.1K | $152.16 | 1.49x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 277 | $44.0K | $158.79 | 1.31x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 2.3K | $43.5K | $19.14 | 1.35x |
| 92201 | Extended examination of eye with drawing of retina | 1.8K | $32.9K | $17.79 | 1.53x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 265 | $28.4K | $107.27 | 1.50x |
| 67145 | Preventive retinal detachment treatment by heat or laser, 1 or more sessions | 75 | $28.3K | $377.85 | 1.38x |
| 92275 | Recording of retinal electrical responses to external stimuli | 221 | $24.8K | $112.21 | 1.43x |
This provider submits charges 1.57 times higher than what Medicare actually pays.
A markup ratio of 1.57x means for every $100 Medicare pays, this provider initially charges $157. 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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