This provider's $4.9M in total Medicare payments ranks in the 99th percentile of Optometry providers nationally.
Medicare payments to this provider grew 54% from 2014 to 2023.
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 | $206.51 | $48.92 | 4.22x | $157.59 | $336.3K | 7.0K | 6.5K |
| 2015 | $209.83 | $47.68 | 4.40x | $162.15 | $302.5K | 6.3K | 5.9K |
| 2016 | $254.08 | $90.29 | 2.81x | $163.79 | $431.6K | 8.9K | 7.8K |
| 2017 | $266.91 | $85.50 | 3.12x | $181.41 | $553.7K | 10.9K | 9.6K |
| 2018 | $261.88 | $83.25 | 3.15x | $178.63 | $616.0K | 11.3K | 10.2K |
| 2019 | $256.92 | $86.58 | 2.97x | $170.34 | $586.7K | 11.0K | 9.7K |
| 2020 | $264.66 | $89.11 | 2.97x | $175.55 | $559.2K | 9.7K | 8.8K |
| 2021 | $562.53 | $98.09 | 5.73x | $464.44 | $533.4K | 8.8K | 7.7K |
| 2022 | $556.35 | $98.81 | 5.63x | $457.54 | $428.5K | 8.0K | 7.1K |
| 2023 | $557.40 | $96.32 | 5.79x | $461.08 | $517.4K | 9.2K | 8.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 65778 | Insertion of amniotic membrane to eye surface | 1.1K | $1.1M | $1.0K | 3.07x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 9.1K | $713.7K | $78.09 | 4.08x |
| 92083 | Measurement of field of vision during daylight conditions | 10.6K | $429.8K | $40.37 | 5.24x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 5.7K | $306.8K | $53.50 | 3.44x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.8K | $264.5K | $70.19 | 4.64x |
| 76513 | Ultrasound of eye using water bath method | 3.7K | $235.2K | $64.06 | 4.17x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 4.0K | $226.5K | $57.24 | 5.60x |
| 92250 | Photography of the retina | 5.8K | $215.5K | $36.86 | 5.63x |
| 83861 | Microfluid analysis of tears | 8.6K | $191.2K | $22.11 | 1.96x |
| 92273 | Full field recording of retinal electrical responses to external stimuli with interpretation and report | 1.9K | $172.6K | $91.26 | 4.38x |
| 92133 | Diagnostic imaging of optic nerve of eye | 6.2K | $165.4K | $26.85 | 4.83x |
| 92020 | Examination of cornea and iris using lens device and slit lamp | 7.2K | $134.8K | $18.60 | 4.64x |
| 92275 | Recording of retinal electrical responses to external stimuli | 1.2K | $128.2K | $105.21 | 3.80x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 996 | $103.2K | $103.58 | 4.24x |
| 92134 | Diagnostic imaging of retina | 3.3K | $91.8K | $27.74 | 4.86x |
| 68761 | Closure of tear duct opening using plug | 820 | $81.1K | $98.93 | 5.88x |
| 92285 | Photography of content of eyes | 5.9K | $80.4K | $13.62 | 4.51x |
| 83516 | Analysis of substance using immunoassay technique | 5.7K | $74.1K | $13.01 | 3.34x |
| 0509T | Pattern recording of retinal electrical responses to external stimuli with interpretation and report | 654 | $32.4K | $49.60 | 6.05x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 794 | $23.1K | $29.07 | 3.77x |
This provider submits charges 4.16 times higher than what Medicare actually pays.
A markup ratio of 4.16x means for every $100 Medicare pays, this provider initially charges $416. 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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