This provider's $9.1M in total Medicare payments ranks in the 99th percentile of Optometry providers nationally.
Medicare payments to this provider grew 17806% from 2014 to 2023.
93% 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 453% 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 |
|---|---|---|---|---|---|---|---|
| 2014 | $125.00 | $79.86 | 1.57x | $45.14 | $6.1K | 91 | 72 |
| 2015 | $113.67 | $72.01 | 1.58x | $41.66 | $13.4K | 188 | 173 |
| 2016 | $131.61 | $62.41 | 2.11x | $69.20 | $26.5K | 420 | 312 |
| 2017 | $306.34 | $141.80 | 2.16x | $164.54 | $146.3K | 1.1K | 582 |
| 2018 | $223.79 | $118.05 | 1.90x | $105.74 | $455.8K | 1.7K | 697 |
| 2019 | $236.95 | $129.48 | 1.83x | $107.47 | $590.1K | 1.8K | 750 |
| 2020 | $224.30 | $124.17 | 1.81x | $100.13 | $938.1K | 2.4K | 864 |
| 2021 | $248.06 | $138.90 | 1.79x | $109.16 | $2.5M | 3.9K | 946 |
| 2022 | $230.88 | $121.47 | 1.90x | $109.41 | $3.4M | 5.1K | 1.2K |
| 2023 | $244.12 | $120.83 | 2.02x | $123.29 | $1.1M | 2.2K | 793 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 65778 | Insertion of amniotic membrane to eye surface | 8.4K | $8.5M | $1.0K | 1.46x |
| 68761 | Closure of tear duct opening using plug | 2.1K | $162.5K | $78.71 | 2.86x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 2.0K | $116.7K | $58.21 | 1.63x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 1.4K | $105.3K | $74.60 | 1.92x |
| 92273 | Full field recording of retinal electrical responses to external stimuli with interpretation and report | 596 | $51.5K | $86.48 | 2.02x |
| 92250 | Photography of the retina | 1.7K | $50.2K | $30.39 | 2.63x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 358 | $31.1K | $86.88 | 1.65x |
| 95930 | Measurement and recording of nerve conduction patterns using visually-evoked stimulation | 444 | $22.1K | $49.87 | 3.51x |
| 92275 | Recording of retinal electrical responses to external stimuli | 133 | $13.6K | $101.97 | 1.73x |
| 92133 | Diagnostic imaging of optic nerve of eye | 476 | $11.8K | $24.81 | 4.43x |
| 92134 | Diagnostic imaging of retina | 383 | $10.2K | $26.62 | 4.14x |
| 92284 | Evaluation of eye adaptation to light and dark | 320 | $10.2K | $31.85 | 3.45x |
| 92020 | Examination of cornea and iris using lens device and slit lamp | 360 | $7.2K | $20.00 | 2.58x |
| 92083 | Measurement of field of vision during daylight conditions | 117 | $4.8K | $41.22 | 3.61x |
| 66984 | Removal of cataract with insertion of lens | 77 | $3.1K | $39.64 | 2.61x |
| 92274 | Multifocal recording of retinal electrical responses to external stimuli with interpretation and report | 27 | $1.6K | $59.32 | 2.95x |
| 76514 | Ultrasound of corneal structure and measurement | 12 | $80.51 | $6.71 | 11.92x |
This provider submits charges 1.52 times higher than what Medicare actually pays.
A markup ratio of 1.52x means for every $100 Medicare pays, this provider initially charges $152. This is lower 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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