This provider's $5.5M 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 | $145.03 | $75.15 | 1.93x | $69.88 | $617.9K | 7.3K | 6.1K |
| 2015 | $145.60 | $75.28 | 1.93x | $70.32 | $489.7K | 5.8K | 4.7K |
| 2016 | $162.71 | $83.85 | 1.94x | $78.86 | $572.0K | 6.0K | 5.2K |
| 2017 | $180.70 | $93.40 | 1.93x | $87.30 | $499.9K | 5.6K | 4.9K |
| 2018 | $182.19 | $94.52 | 1.93x | $87.67 | $576.3K | 6.3K | 5.3K |
| 2019 | $186.34 | $99.47 | 1.87x | $86.87 | $578.4K | 6.5K | 5.5K |
| 2020 | $182.06 | $98.62 | 1.85x | $83.44 | $543.7K | 6.1K | 5.4K |
| 2021 | $175.38 | $97.42 | 1.80x | $77.96 | $505.9K | 5.7K | 5.3K |
| 2022 | $174.00 | $93.34 | 1.86x | $80.66 | $487.1K | 5.6K | 5.0K |
| 2023 | $149.59 | $80.48 | 1.86x | $69.11 | $638.5K | 6.7K | 5.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 14.9K | $1.7M | $111.21 | 1.52x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 19.6K | $1.5M | $78.77 | 2.16x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 7.9K | $1.1M | $133.77 | 1.44x |
| 92250 | Photography of the retina | 7.4K | $334.4K | $45.44 | 2.74x |
| 92273 | Full field recording of retinal electrical responses to external stimuli with interpretation and report | 1.8K | $221.3K | $122.46 | 1.84x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 1.6K | $132.1K | $81.41 | 1.90x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 1.1K | $115.9K | $109.13 | 1.28x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 601 | $69.5K | $115.57 | 1.60x |
| 92020 | Examination of cornea and iris using lens device and slit lamp | 2.7K | $65.9K | $23.99 | 2.70x |
| 92275 | Recording of retinal electrical responses to external stimuli | 470 | $64.1K | $136.45 | 1.65x |
| 68761 | Closure of tear duct opening using plug | 350 | $56.0K | $159.99 | 2.39x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 406 | $49.5K | $121.86 | 1.61x |
| 99326 | New patient assisted living visit, typically 45 minutes | 236 | $28.1K | $119.22 | 1.80x |
| 76514 | Ultrasound of corneal structure and measurement | 1.4K | $16.9K | $11.70 | 2.56x |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 95 | $15.0K | $157.59 | 1.33x |
| 99337 | Established patient assisted living visit, typically 60 minutes | 83 | $12.8K | $154.64 | 1.58x |
| 99327 | New patient assisted living visit, typically 60 minutes | 68 | $10.6K | $156.54 | 1.52x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 162 | $9.5K | $58.77 | 2.30x |
| 99345 | New patient home visit, typically 75 minutes | 46 | $8.3K | $179.77 | 1.46x |
| 67820 | Removal of eyelashes by forceps | 178 | $8.0K | $44.70 | 2.89x |
This provider submits charges 1.81 times higher than what Medicare actually pays.
A markup ratio of 1.81x means for every $100 Medicare pays, this provider initially charges $181. 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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