Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Oklahoma for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Oklahoma only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Oklahoma (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Darin Haivala (NPI 1689641342)

Field	Value
Entity Type	Individual
Organization	Darin Haivala
Address	12318 Saint Andrews Dr
City	Oklahoma City
State	OK
ZIP	73120
Taxonomy	Ophthalmology Physician
NPI Enumerated	March 1, 2006

Payer Source	Total Paid
Medicare	$1.5M
Medicaid	$0

Key Findings

Practice appears to be a retina-focused ophthalmology operation driven by intravitreal anti-VEGF therapy: the top revenue codes are J0178 (aflibercept), J2777 (faricimab), and the intravitreal injection procedure 67028, and the code descriptions tie to recurring in-office injections and retina disease management rather than broad general ophthalmology procedures. High-volume retinal imaging codes (92134, 92250) in the profile further support a chronic retinal disease caseload with ongoing monitoring and treatment cycles.

Revenue is highly concentrated in a small set of Medicare codes: the precomputed top-3 Medicare codes account for 85.2% of this provider's total Medicare revenue, with J0178 contributing 55.7%, J2777 contributing 21.7%, and 67028 contributing 7.9% of total Medicare revenue. This concentration indicates most Medicare dollars come from recurring injections and associated administration rather than a broad mix of office or surgical visits.

The provider’s payer mix is effectively single-payer Medicare: lifetime Medicare revenue is $1.5M while there is no Medicaid billing on file. This means the practice’s revenue profile and any utilization patterns observed here are entirely Medicare-driven, with no Medicaid reimbursement data to offset or diversify the picture.

Competitive standing for the primary drug administrations is modest to typical nationally: J0178 ranks #1095 of 3204 providers nationally (66th percentile; typical, unremarkable volume for this code) and J2777 ranks #934 of 2039 providers nationally (54th percentile; typical, unremarkable volume for this code). Although the provider bills meaningful dollar amounts for these injectables, the percentile ranks indicate they are not a dominant national outlier for anti-VEGF administration.

Several diagnostic and monitoring codes are statistical outliers on the high side, consistent with a monitoring-heavy retina practice: 92012 ranks #740 of 17177 providers nationally (96th percentile; notably above typical national volume for this code), 92134 ranks #1160 of 26868 providers nationally (96th percentile; notably above typical national volume for this code), and 92250 ranks #685 of 25087 providers nationally (97th percentile; notably above typical national volume for this code). High percentiles on intermediate/comprehensive established exam codes and retinal imaging suggest substantial follow-up and imaging throughput supporting the injection service line.

Surgical and advanced operative volume is limited relative to injection care: the intravitreal injection procedure 67028 has 1.4K claims and ranks #862 of 4255 providers nationally (80th percentile; typical, unremarkable volume for this code), while a vitreoretinal surgery code 67041 shows only 15 claims and ranks #269 of 461 providers nationally (33th percentile; typical, unremarkable volume for this code). This mix implies the practice focuses more on office-based therapeutic injections and imaging than on higher-volume surgical retinal interventions.

Tenure in Medicare is long-standing: the NPI was enumerated on 2006-03-01 (~20 years ago), indicating roughly two decades of being established in Medicare billing. That longevity supports interpretation of the billing mix as a stable practice pattern rather than a short-term anomaly.

From a payer-management and network strategy perspective, the provider’s heavy dependence on a few high-cost drug administrations and Medicare reimbursement means changes to drug coverage, reimbursement levels, or administration policy could materially impact revenue. The lack of reported Medicaid activity removes a potential avenue for payer diversification and suggests network negotiations or care-access considerations should be evaluated with the understanding this is an essentially Medicare-only billing profile.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	1,200	$690	$827.8K
J2777	Injection, faricimab‑svoa, 0.1 mg	11,100	$30	$321.9K
67028	The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.	1,430	$80	$117.3K
92012	For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any…	820	$60	$47.7K
J9035	Injection, bevacizumab, 10 mg	820	$50	$44.5K
92134	The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes.	1,870	$20	$43K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	440	$80	$36.3K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	190	$100	$19K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	670	$20	$16K
67041	In this procedure, the provider removes scar tissue from the retinal membrane that obscures vision. He removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical…	20	$810	$12.2K

Showing 1–10 of 11

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 11 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Oklahoma Distribution

Darin Haivala — 3 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oklahoma

Full comparison — all codes billed, vs. state median

11 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	9	30	790	$690	$801.2K
J2777	13	20	23,040	$30	$781.1K
67028	12	40	720	$80	$88.9K
J9035	6	30	330	$50	$23.5K
67041	4	10	20	$1,010	$18.2K
92014	55	550	130	$70	$16.6K
92012	3	220	60	$50	$6.4K
92134	14	460	50	$30	$5.4K
92004	25	430	40	$90	$5.4K
92250	4	420	70	$20	$2.7K

Showing 1–10 of 11

Related Providers

Other providers that share a Tax Identification Number (TIN) with Darin Haivala, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Robert Leonard	OK	Retina Specialist (Ophthalmology) Physician	$1.7M	$0
Jared Jackson	OK	Ophthalmology Physician	$341.8K	$0
Darrell Pickard	OK	Ophthalmology Physician	$312.2K	$0
Joshua Jones	KS	Student in an Organized Health Care Education/Training Program	$230.6K	$0
Jeffrey Shaver	OK	Ophthalmology Physician	$195.9K	$0
Charles Bogie	OK	Ophthalmology Physician	$160K	$0
Natalie Mccord	OK	Optometrist	$97.6K	$0
Selina Mcgee	OK	Optometrist	$56.1K	$0

Nearby Providers

Other providers in the same ZIP code as Darin Haivala, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Clinic Oklahoma Communities	OK	Family Medicine Physician	$0	$45.4M
Mercy Hospital Oklahoma City, Inc	OK	General Acute Care Hospital	$0	$14.2M
Osu Center For Health Sciences	OK	Clinic/Center	$0	$11.6M
The Perinatal Center, PLLC	OK	Maternal & Fetal Medicine Physician	$0	$7.6M
Oklahoma Spine Surgery Center	OK	Ambulatory Surgical Clinic/Center	$6.8M	$708.6K
Childrens Eye Care P L L C	OK	Ophthalmology Physician	$0	$5.8M
Marquis Labs, LLC	OK	Clinical Medical Laboratory	$718.2K	$4.8M
Beacon Pointe, LLC	OK	Community/Behavioral Health Agency	$0	$3.5M
Ohh Physicians, LLC	OK	Cardiovascular Disease Physician	$0	$3.4M
Caring Home Health Agency Inc	OK	Home Health Agency	$0	$2.8M

Darin Haivala — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References