This provider's $6.4M in total Medicare payments ranks in the 99th percentile of Optometry providers nationally.
Medicare payments to this provider grew 31378% from 2018 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 14129% in 2019
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 |
|---|---|---|---|---|---|---|---|
| 2018 | $132.50 | $63.75 | 2.08x | $68.75 | $5.9K | 97 | 96 |
| 2019 | $236.53 | $108.48 | 2.18x | $128.05 | $842.5K | 9.9K | 5.9K |
| 2020 | $257.52 | $116.40 | 2.21x | $141.12 | $1.0M | 11.0K | 6.4K |
| 2021 | $244.21 | $117.37 | 2.08x | $126.84 | $1.3M | 15.2K | 9.5K |
| 2022 | $226.47 | $101.57 | 2.23x | $124.90 | $1.3M | 18.1K | 11.0K |
| 2023 | $236.42 | $104.01 | 2.27x | $132.41 | $1.9M | 19.8K | 11.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 65778 | Insertion of amniotic membrane to eye surface | 2.5K | $3.0M | $1.2K | 2.07x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 12.0K | $823.6K | $68.40 | 2.17x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 5.3K | $477.5K | $90.56 | 2.34x |
| 68761 | Closure of tear duct opening using plug | 6.3K | $437.2K | $69.41 | 2.98x |
| 83861 | Microfluid analysis of tears | 19.7K | $434.8K | $22.09 | 1.63x |
| 92273 | Full field recording of retinal electrical responses to external stimuli with interpretation and report | 2.1K | $230.7K | $108.09 | 2.07x |
| 92134 | Diagnostic imaging of retina | 7.2K | $214.6K | $29.82 | 2.32x |
| 92283 | Extended color vision examination | 4.2K | $180.2K | $42.77 | 2.18x |
| 92083 | Measurement of field of vision during daylight conditions | 3.4K | $152.0K | $44.74 | 2.41x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 1.2K | $112.5K | $92.11 | 2.74x |
| 92133 | Diagnostic imaging of optic nerve of eye | 3.0K | $83.5K | $27.53 | 2.27x |
| 92284 | Evaluation of eye adaptation to light and dark (rods and cones) | 1.7K | $72.3K | $43.42 | 2.27x |
| 92250 | Photography of the retina | 2.1K | $62.6K | $29.90 | 2.57x |
| 92201 | Extended examination of eye with drawing of retina | 1.2K | $22.2K | $18.89 | 2.26x |
| 92020 | Examination of cornea and iris using lens device and slit lamp | 742 | $15.1K | $20.31 | 2.27x |
| 92002 | Eye and medical examination for diagnosis and treatment, new patient | 158 | $8.8K | $55.87 | 2.54x |
| 92025 | Computerized mapping of corneal curvature | 239 | $6.6K | $27.50 | 2.22x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 140 | $6.1K | $43.23 | 2.82x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 264 | $5.9K | $22.44 | 2.05x |
| 76514 | Ultrasound of corneal structure and measurement | 298 | $2.4K | $8.08 | 3.18x |
This provider submits charges 2.18 times higher than what Medicare actually pays.
A markup ratio of 2.18x means for every $100 Medicare pays, this provider initially charges $218. This is higher than the national average.
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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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