This provider's $9.1M 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 | $742.02 | $298.78 | 2.48x | $443.24 | $895.4K | 8.2K | 4.2K |
| 2015 | $688.45 | $232.29 | 2.96x | $456.16 | $747.9K | 7.9K | 4.1K |
| 2016 | $693.70 | $236.49 | 2.93x | $457.21 | $845.9K | 8.6K | 4.4K |
| 2017 | $651.55 | $211.85 | 3.08x | $439.70 | $826.4K | 8.5K | 4.3K |
| 2018 | $1.1K | $338.91 | 3.38x | $808.03 | $1.0M | 9.0K | 4.6K |
| 2019 | $1.0K | $313.12 | 3.26x | $707.68 | $961.8K | 8.3K | 4.2K |
| 2020 | $1.2K | $333.47 | 3.63x | $877.26 | $984.8K | 8.2K | 4.1K |
| 2021 | $1.0K | $312.77 | 3.33x | $727.92 | $973.6K | 8.2K | 4.0K |
| 2022 | $1.3K | $348.81 | 3.61x | $911.62 | $962.2K | 8.1K | 3.9K |
| 2023 | $1.3K | $346.46 | 3.78x | $961.82 | $917.4K | 7.7K | 3.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 2.1K | $1.5M | $741.92 | 2.15x |
| 67028 | Injection of drug into eye | 14.8K | $1.3M | $88.14 | 7.71x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 9.3K | $817.5K | $87.58 | 1.95x |
| 92134 | Diagnostic imaging of retina | 21.8K | $674.9K | $30.98 | 3.16x |
| 67042 | Removal of membrane from the retina, pars plana approach | 641 | $591.6K | $922.86 | 2.46x |
| J2778 | Injection, ranibizumab, 0.1 mg | 2.0K | $564.3K | $282.86 | 2.11x |
| 67039 | Laser destruction of eye fluid (vitreous) between the lens and retina | 677 | $515.7K | $761.75 | 4.42x |
| J7999 | Compounded drug, not otherwise classified | 7.1K | $470.2K | $66.02 | 2.49x |
| 99214 | Established patient outpatient visit, total time 30-39 minutes | 4.0K | $366.4K | $91.37 | 2.96x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 4.7K | $363.5K | $77.19 | 2.54x |
| 92242 | Imaging of blood vessels in back of eye using fluorescein and indocyanine-green dye | 2.0K | $358.4K | $177.94 | 2.35x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 1.6K | $174.0K | $106.12 | 1.98x |
| 92240 | Examination of eye using an endoscope | 824 | $156.2K | $189.53 | 1.71x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 141 | $135.7K | $962.52 | 2.93x |
| 92250 | Photography of the retina | 3.8K | $124.0K | $32.83 | 3.41x |
| 66820 | Removal of recurring cataract in lens capsule | 666 | $114.0K | $171.21 | 4.75x |
| J3590 | Unclassified biologics | 62 | $105.6K | $1.7K | 4.54x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 99 | $98.5K | $995.44 | 2.96x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.8K | $91.4K | $51.76 | 1.93x |
| J3490 | Unclassified drugs | 52 | $86.6K | $1.7K | 4.81x |
This provider submits charges 3.39 times higher than what Medicare actually pays.
A markup ratio of 3.39x means for every $100 Medicare pays, this provider initially charges $339. 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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