This provider's $4.1M 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 | $159.27 | $85.23 | 1.87x | $74.04 | $446.1K | 4.7K | 4.1K |
| 2015 | $151.49 | $81.62 | 1.86x | $69.87 | $362.8K | 4.2K | 3.3K |
| 2016 | $276.33 | $174.25 | 1.59x | $102.08 | $388.0K | 4.0K | 3.4K |
| 2017 | $317.43 | $183.38 | 1.73x | $134.05 | $379.4K | 3.9K | 3.3K |
| 2018 | $373.85 | $224.19 | 1.67x | $149.66 | $404.0K | 4.1K | 3.4K |
| 2019 | $387.05 | $236.14 | 1.64x | $150.91 | $393.3K | 3.8K | 3.1K |
| 2020 | $318.85 | $192.16 | 1.66x | $126.69 | $411.8K | 3.6K | 3.2K |
| 2021 | $361.71 | $230.15 | 1.57x | $131.56 | $409.8K | 3.9K | 3.4K |
| 2022 | $352.29 | $215.80 | 1.63x | $136.49 | $374.6K | 3.7K | 3.3K |
| 2023 | $174.34 | $94.98 | 1.84x | $79.36 | $481.3K | 4.8K | 4.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 17.0K | $1.3M | $76.90 | 2.22x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 10.0K | $1.1M | $106.60 | 1.58x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 6.6K | $855.9K | $129.36 | 1.50x |
| 68761 | Closure of tear duct opening using plug | 1.3K | $208.1K | $160.34 | 2.21x |
| 65778 | Insertion of amniotic membrane to eye surface | 127 | $163.3K | $1.3K | 1.41x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 964 | $104.4K | $108.29 | 1.29x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 1.2K | $92.3K | $78.20 | 1.97x |
| 92250 | Photography of the retina | 1.2K | $51.7K | $44.21 | 2.78x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 389 | $44.8K | $115.17 | 1.61x |
| 99326 | New patient assisted living visit, typically 45 minutes | 357 | $42.2K | $118.09 | 1.82x |
| 76512 | Ultrasound of eye disease, growth, or structure | 434 | $33.0K | $75.98 | 1.97x |
| 92060 | Exam to measure eye deviation and range of motion | 433 | $23.6K | $54.44 | 2.11x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 161 | $19.0K | $117.80 | 1.69x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 262 | $15.3K | $58.27 | 2.36x |
| 99344 | New patient home visit, typically 60 minutes | 55 | $8.1K | $147.54 | 1.52x |
| 92020 | Examination of cornea and iris using lens device and slit lamp | 218 | $5.0K | $22.91 | 2.84x |
| 99349 | Established patient home visit, typically 40 minutes | 31 | $3.2K | $102.68 | 1.74x |
| 76519 | Ultrasound of eye for determination of lens power | 39 | $2.9K | $73.55 | 2.04x |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 15 | $2.3K | $152.20 | 1.38x |
| 67820 | Removal of eyelashes by forceps | 19 | $982.74 | $51.72 | 2.67x |
This provider submits charges 1.83 times higher than what Medicare actually pays.
A markup ratio of 1.83x means for every $100 Medicare pays, this provider initially charges $183. 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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