This provider's $3.3M in total Medicare payments ranks in the 99th percentile of Optometry providers nationally.
Medicare payments to this provider grew 534% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 347% 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 | $151.79 | $86.54 | 1.75x | $65.25 | $88.4K | 873 | 861 |
| 2015 | $112.69 | $66.55 | 1.69x | $46.14 | $395.2K | 4.7K | 4.3K |
| 2016 | $112.78 | $64.36 | 1.75x | $48.42 | $453.2K | 5.6K | 4.8K |
| 2017 | $112.64 | $58.56 | 1.92x | $54.08 | $393.0K | 5.7K | 5.2K |
| 2018 | $112.64 | $57.49 | 1.96x | $55.15 | $213.6K | 3.2K | 2.7K |
| 2019 | $112.64 | $61.13 | 1.84x | $51.51 | $296.4K | 4.2K | 3.6K |
| 2020 | $121.13 | $57.43 | 2.11x | $63.70 | $164.4K | 2.4K | 2.2K |
| 2021 | $121.40 | $59.39 | 2.04x | $62.01 | $354.1K | 4.9K | 4.3K |
| 2022 | $121.19 | $58.72 | 2.06x | $62.47 | $419.7K | 5.7K | 4.8K |
| 2023 | $121.90 | $58.06 | 2.10x | $63.84 | $560.7K | 7.4K | 6.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 10.6K | $1.4M | $130.46 | 1.76x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 10.8K | $1.1M | $105.88 | 1.75x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 5.7K | $427.0K | $74.38 | 1.65x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 4.7K | $108.0K | $23.16 | 2.17x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 3.9K | $81.5K | $20.91 | 2.05x |
| 92201 | Extended examination of eye with drawing of retina | 2.9K | $62.5K | $21.86 | 2.57x |
| 92002 | Eye and medical examination for diagnosis and treatment, new patient | 697 | $50.4K | $72.34 | 1.60x |
| 92202 | Extended examination of eye with drawing of optic nerve and surrounding area (macula) | 3.0K | $39.9K | $13.42 | 2.63x |
| 92250 | Photography of the retina | 1.9K | $34.4K | $18.44 | 9.84x |
| 92285 | Photography of content of eyes | 494 | $9.6K | $19.34 | 2.51x |
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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