This provider's $4.0M in total Medicare payments ranks in the 99th percentile of Optometry 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 | $140.92 | $83.56 | 1.69x | $57.36 | $408.3K | 7.2K | 4.3K |
| 2015 | $162.53 | $88.90 | 1.83x | $73.63 | $461.4K | 8.1K | 4.8K |
| 2016 | $178.64 | $88.34 | 2.02x | $90.30 | $422.0K | 7.0K | 3.9K |
| 2017 | $171.18 | $80.32 | 2.13x | $90.86 | $397.8K | 6.8K | 4.0K |
| 2018 | $177.95 | $85.12 | 2.09x | $92.83 | $336.0K | 6.3K | 3.8K |
| 2019 | $193.48 | $90.77 | 2.13x | $102.71 | $359.7K | 6.0K | 3.8K |
| 2020 | $197.77 | $93.00 | 2.13x | $104.77 | $408.9K | 5.5K | 3.6K |
| 2021 | $201.82 | $93.88 | 2.15x | $107.94 | $412.9K | 6.0K | 3.8K |
| 2022 | $210.53 | $91.74 | 2.29x | $118.79 | $408.8K | 6.2K | 3.8K |
| 2023 | $213.92 | $91.68 | 2.33x | $122.24 | $424.4K | 6.9K | 3.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 65778 | Insertion of amniotic membrane to eye surface | 1.1K | $1.1M | $1.0K | 1.47x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 6.1K | $480.4K | $78.63 | 1.53x |
| 92250 | Photography of the retina | 11.6K | $477.6K | $41.22 | 2.06x |
| 68761 | Closure of tear duct opening using plug | 2.3K | $304.2K | $131.58 | 2.87x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 4.7K | $260.1K | $55.15 | 1.55x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.5K | $206.9K | $81.28 | 1.66x |
| 83861 | Microfluid analysis of tears | 8.7K | $192.2K | $22.06 | 1.59x |
| 92134 | Diagnostic imaging of retina | 5.7K | $171.9K | $29.98 | 2.73x |
| 83516 | Analysis of substance using immunoassay technique | 7.5K | $99.3K | $13.18 | 2.28x |
| 92273 | Full field recording of retinal electrical responses to external stimuli with interpretation and report | 1.0K | $97.1K | $96.10 | 3.64x |
| 76512 | Ultrasound of eye disease, growth, or structure | 1.5K | $79.2K | $54.12 | 2.31x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 865 | $50.2K | $58.07 | 1.89x |
| 92133 | Diagnostic imaging of optic nerve of eye | 1.7K | $47.7K | $27.60 | 2.92x |
| 92083 | Measurement of field of vision during daylight conditions | 1.1K | $46.5K | $42.91 | 1.98x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 493 | $46.1K | $93.42 | 1.57x |
| 95930 | Measurement and recording of nerve conduction patterns using visually-evoked stimulation | 826 | $46.0K | $55.69 | 6.29x |
| 92284 | Evaluation of eye adaptation to light and dark (rods and cones) | 1.2K | $43.4K | $36.78 | 4.00x |
| 92275 | Recording of retinal electrical responses to external stimuli | 367 | $38.2K | $104.20 | 3.33x |
| 92286 | Microscopic evaluation of deep cells of the eye | 1.3K | $34.5K | $27.07 | 5.54x |
| 66984 | Removal of cataract with insertion of lens | 269 | $24.4K | $90.63 | 1.43x |
This provider submits charges 2.04 times higher than what Medicare actually pays.
A markup ratio of 2.04x means for every $100 Medicare pays, this provider initially charges $204. 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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