This provider's $8.1M in total Medicare payments ranks in the 99th percentile of Optometry providers nationally.
Medicare payments to this provider grew 389% from 2016 to 2023.
66% of their billing comes from a single procedure code (65778 — Insertion of amniotic membrane to eye surface).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 70% in 2017
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 |
|---|---|---|---|---|---|---|---|
| 2016 | $659.34 | $294.53 | 2.24x | $364.81 | $378.4K | 661 | 461 |
| 2017 | $668.29 | $341.01 | 1.96x | $327.28 | $644.0K | 1.0K | 745 |
| 2018 | $714.83 | $342.53 | 2.09x | $372.30 | $672.9K | 1.1K | 781 |
| 2019 | $580.41 | $282.62 | 2.05x | $297.79 | $841.2K | 2.4K | 1.3K |
| 2020 | $265.31 | $126.15 | 2.10x | $139.16 | $856.8K | 4.8K | 3.5K |
| 2021 | $244.07 | $116.71 | 2.09x | $127.36 | $1.4M | 16.5K | 9.8K |
| 2022 | $256.10 | $113.72 | 2.25x | $142.38 | $1.4M | 17.9K | 10.3K |
| 2023 | $254.06 | $111.27 | 2.28x | $142.79 | $1.9M | 19.6K | 11.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 65778 | Insertion of amniotic membrane to eye surface | 4.5K | $5.4M | $1.2K | 2.05x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 9.1K | $635.1K | $69.58 | 2.12x |
| 68761 | Closure of tear duct opening using plug | 5.6K | $385.1K | $68.81 | 3.07x |
| 83861 | Microfluid analysis of tears | 17.0K | $377.5K | $22.16 | 1.62x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 3.7K | $337.3K | $91.27 | 2.32x |
| 92273 | Full field recording of retinal electrical responses to external stimuli with interpretation and report | 2.9K | $316.4K | $108.27 | 2.03x |
| 92134 | Diagnostic imaging of retina | 5.1K | $150.6K | $29.67 | 2.31x |
| 92283 | Extended color vision examination | 2.6K | $111.2K | $42.76 | 2.17x |
| 92083 | Measurement of field of vision during daylight conditions | 2.5K | $107.7K | $42.94 | 2.49x |
| 92025 | Computerized mapping of corneal curvature | 3.3K | $89.8K | $27.38 | 2.24x |
| 92133 | Diagnostic imaging of optic nerve of eye | 2.7K | $72.3K | $27.24 | 2.29x |
| 92250 | Photography of the retina | 2.1K | $57.8K | $28.02 | 2.78x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 417 | $37.9K | $90.91 | 2.77x |
| 92284 | Evaluation of eye adaptation to light and dark (rods and cones) | 641 | $28.2K | $44.06 | 2.25x |
| 92020 | Examination of cornea and iris using lens device and slit lamp | 682 | $14.5K | $21.22 | 2.17x |
| 92002 | Eye and medical examination for diagnosis and treatment, new patient | 192 | $9.7K | $50.40 | 2.81x |
| 76514 | Ultrasound of corneal structure and measurement | 703 | $6.0K | $8.49 | 2.72x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 51 | $1.9K | $36.38 | 2.03x |
| 92201 | Extended examination of eye with drawing of retina | 68 | $1.4K | $20.68 | 2.08x |
| 68801 | Dilation of tear-drainage opening | 22 | $1.1K | $50.28 | 5.01x |
This provider submits charges 2.12 times higher than what Medicare actually pays.
A markup ratio of 2.12x means for every $100 Medicare pays, this provider initially charges $212. 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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