This provider's $4.2M in total Medicare payments ranks in the 99th percentile of Optometry providers nationally.
Medicare payments to this provider grew 458% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 258% in 2015
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 | $159.86 | $91.42 | 1.75x | $68.44 | $96.2K | 1.1K | 1.1K |
| 2015 | $127.47 | $74.50 | 1.71x | $52.97 | $344.7K | 4.1K | 3.1K |
| 2016 | $157.00 | $82.70 | 1.90x | $74.30 | $453.6K | 4.9K | 4.3K |
| 2017 | $177.31 | $78.71 | 2.25x | $98.60 | $470.9K | 4.8K | 3.8K |
| 2018 | $189.99 | $90.65 | 2.10x | $99.34 | $391.6K | 4.1K | 3.5K |
| 2019 | $180.55 | $99.01 | 1.82x | $81.54 | $443.6K | 4.9K | 4.1K |
| 2020 | $196.67 | $107.43 | 1.83x | $89.24 | $466.4K | 5.2K | 4.4K |
| 2021 | $187.26 | $98.95 | 1.89x | $88.31 | $533.6K | 6.2K | 5.1K |
| 2022 | $188.10 | $96.48 | 1.95x | $91.62 | $491.5K | 6.1K | 5.0K |
| 2023 | $169.64 | $94.20 | 1.80x | $75.44 | $536.5K | 6.5K | 5.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 14.6K | $1.6M | $111.94 | 1.53x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 11.3K | $887.6K | $78.67 | 2.15x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 5.4K | $722.1K | $134.38 | 1.45x |
| 92250 | Photography of the retina | 11.1K | $418.6K | $37.84 | 3.30x |
| 68761 | Closure of tear duct opening using plug | 828 | $152.6K | $184.27 | 2.54x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 1.3K | $109.2K | $81.25 | 1.89x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 784 | $85.9K | $109.59 | 1.28x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 628 | $73.1K | $116.45 | 1.59x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 570 | $66.0K | $115.72 | 1.68x |
| 99326 | New patient assisted living visit, typically 45 minutes | 303 | $35.9K | $118.55 | 1.81x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 238 | $14.1K | $59.05 | 2.26x |
| 92020 | Examination of cornea and iris using lens device and slit lamp | 399 | $9.3K | $23.33 | 2.77x |
| 99344 | New patient home visit, typically 60 minutes | 25 | $3.7K | $148.71 | 1.55x |
| 76519 | Ultrasound of eye for determination of lens power | 50 | $3.6K | $71.17 | 2.11x |
| 76514 | Ultrasound of corneal structure and measurement | 272 | $3.5K | $12.93 | 2.32x |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 14 | $2.2K | $157.55 | 1.33x |
| 99345 | New patient home visit, typically 75 minutes | 12 | $2.2K | $179.75 | 1.45x |
| 92060 | Exam to measure eye deviation and range of motion | 29 | $1.7K | $57.20 | 2.01x |
| 99349 | Established patient home visit, typically 40 minutes | 11 | $1.2K | $106.25 | 1.74x |
| 92285 | Photography of content of eyes | 39 | $845.02 | $21.67 | 5.08x |
This provider submits charges 1.87 times higher than what Medicare actually pays.
A markup ratio of 1.87x means for every $100 Medicare pays, this provider initially charges $187. 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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