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NPI 1982759221 · Phoenix, AZ · Ophthalmology Physician
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Karim Jamal is a ophthalmology physician provider located in Phoenix, Arizona. This profile covers 23 Medicare and 4 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Karim Jamal |
| Address | 1101 E Missouri Ave |
| City | Phoenix |
| State | AZ |
| ZIP | 85014 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | January 25, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.1M |
| Medicaid | $7.7K |
KARIM JAMAL is a long-tenured Ophthalmology Physician (NPI enumerated 2007-01-25, ~19 years ago) whose billing profile is overwhelmingly Medicare-facing: total Medicare revenue is $3.1M versus total Medicaid revenue of $7.7K, indicating the provider operates effectively as a Medicare-fed practice rather than relying on Medicaid volume. The scale difference suggests payer strategy and patient mix are concentrated in the Medicare population.
Medicare revenue is highly concentrated in a small set of retinal drug codes: the top 3 Medicare codes account for 65.1% of this provider's Medicare revenue, driven by J2777 ($901.3K, 29.1%), Q5128 ($606.1K, 19.6%), and J0178 ($508.7K, 16.4%). This concentration signals that intravitreal biologic therapies are the primary revenue engine for the practice on Medicare.
The procedure and service mix confirms a retina-focused, injection-heavy operation: high-revenue Medicare items include drug injections J2777, Q5128, J0178 and the intravitreal procedure 67028 (1.9K claims, $181.8K, 5.9% of Medicare revenue). Diagnostic retinal imaging is also present — 92134 generates $55.3K (1.8% of Medicare revenue) and 2K claims — indicating regular use of OCT imaging to manage retinal disease in conjunction with frequent anti-VEGF therapy.
Competitive standing across specific Medicare codes is mixed: for J2777 the provider ranks #281 of 2039 (86th percentile), indicating an above-median national presence for faricimab injections but characterized as typical volume; Q5128 is especially strong at #40 of 373 (90th percentile), showing a relatively high national position for the ranibizumab biosimilar; by contrast J0178 sits near the median at #1585 of 3204 (50th percentile), reflecting an average national footprint for aflibercept. These rank/percentile positions imply the practice is a meaningful regional participant for certain biosimilars and newer agents while being average for older branded agents.
Medicaid activity is minimal and tightly concentrated: the top 3 Medicaid codes account for 90.2% of Medicaid revenue, led by 92134 ($3.5K, 44.9%), 92014 ($2.3K, 30.0%), and 67028 ($1.2K, 15.3%). Overall Medicaid receipts total only $7.7K, so even the highest-ranking Medicaid codes represent trivial absolute revenue compared with Medicare activity.
The provider’s competitive position within Arizona Medicaid is modest to weak: 92134 ranks #43 of 65 in-state (34th percentile), 92014 ranks #123 of 149 (17th percentile), and 67028 ranks #28 of 31 (7th percentile). Those in-state percentiles indicate the provider is not a leading Medicaid retinal services provider in Arizona and captures only a small share of state Medicaid procedural volume.
Clinical office visits and E/M work constitute a small portion of revenue relative to injections and imaging: Medicare 92014 (515 claims, $44.8K, 1.4% of Medicare revenue) and 99214 (337 claims, $29K, 0.9% of Medicare revenue) are present but represent low single-digit shares of Medicare revenue. This pattern is consistent with a procedure-driven retinal practice where visit-level billing supports, rather than drives, overall revenue.
There are notable statistical signals at the code level: 92134 is described as "notably above typical national volume" (96th percentile), marking OCT imaging as a relative outlier upward in national comparison and suggesting intensive imaging use on Medicare patients; conversely, codes like J0179 (brolucizumab) rank very low nationally (#61 of 64, 5th percentile) and J3490 ranks low nationally (#2509 of 2838, 10th percentile), indicating limited use of these items despite occasional high average paid/claim values. These contrasts point to selective adoption of certain drugs and high imaging intensity while other therapies remain rarely used.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
23 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 31,080 | $30 | $901.3K |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 2,810 | $220 | $606.1K |
| J0178 | Injection, aflibercept, 1 mg | 730 | $700 | $508.7K |
| J2778 | Injection, ranibizumab, 0.1 mg | 2,530 | $190 | $468.2K |
| 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. | 1,930 | $90 | $181.8K |
| 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. | 1,980 | $30 | $55.3K |
| 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… | 520 | $90 | $44.8K |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 260 | $160 | $40.9K |
| 92242 | The provider injects two different special dyes into one or both eyes that cause the blood vessels to stand out in photographic images timed so that multiple frames are taken in rapid succession. He… | 210 | $190 | $40K |
| J3490 | Unclassified drugs | 20 | $1,690 | $38.9K |
Showing 1–10 of 23
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 23 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
23 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 28 | 50 | 780 | $690 | $734.8K |
| J2777 | 11 | 50 | 9,000 | $30 | $525.8K |
| Q5124 | 6 | 10 | 1,250 | $170 | $209.2K |
| Q5128 | 2 | 20 | 520 | $220 | $207.5K |
| J2778 | 4 | 30 | 550 | $180 | $198K |
| 67028 | 16 | 60 | 1,240 | $90 | $119K |
| J0179 | 3 | 10 | 370 | $250 | $76.9K |
| J7312 | 13 | 20 | 270 | $160 | $48.9K |
| J7999 | 34 | 50 | 490 | $70 | $46.8K |
| 67042 | 33 | 40 | 30 | $1,160 | $46.5K |
Showing 1–10 of 23
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 120 | $30 | $3.5K |
| 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… | 30 | $90 | $2.3K |
| 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. | 20 | $80 | $1.2K |
| 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… | 10 | $50 | $760 |
How this provider's Medicaid billing volume and revenue compare to other Arizona providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Arizona median
4 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 123 | 150 | 250 | $60 | $293.9K |
| 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. | 28 | 30 | 380 | $70 | $266.2K |
| 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… | 81 | 90 | 380 | $50 | $192.2K |
| 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. | 43 | 70 | 300 | $20 | $98.9K |
Other providers in the same ZIP code as Karim Jamal, ranked by combined Medicare and Medicaid revenue.
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