This provider's $5.1M 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 | $147.01 | $82.21 | 1.79x | $64.80 | $390.0K | 4.4K | 3.4K |
| 2015 | $147.11 | $74.74 | 1.97x | $72.37 | $353.2K | 3.9K | 3.3K |
| 2016 | $158.12 | $76.55 | 2.07x | $81.57 | $507.8K | 5.5K | 4.6K |
| 2017 | $166.29 | $83.47 | 1.99x | $82.82 | $529.1K | 5.9K | 4.9K |
| 2018 | $143.35 | $71.12 | 2.02x | $72.23 | $531.4K | 5.4K | 4.4K |
| 2019 | $158.00 | $79.76 | 1.98x | $78.24 | $554.8K | 5.6K | 4.4K |
| 2020 | $160.00 | $81.29 | 1.97x | $78.71 | $462.6K | 4.5K | 4.0K |
| 2021 | $171.67 | $100.65 | 1.71x | $71.02 | $580.4K | 5.7K | 4.7K |
| 2022 | $171.67 | $99.84 | 1.72x | $71.83 | $618.4K | 6.2K | 5.0K |
| 2023 | $171.67 | $97.81 | 1.76x | $73.86 | $562.3K | 5.7K | 4.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 24.4K | $2.5M | $101.68 | 1.97x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 12.4K | $1.5M | $120.99 | 1.78x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 14.9K | $1.1M | $70.97 | 1.41x |
| 92002 | Eye and medical examination for diagnosis and treatment, new patient | 429 | $27.6K | $64.39 | 2.33x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 323 | $12.5K | $38.57 | 1.82x |
| 67820 | Removal of eyelashes by forceps | 174 | $5.3K | $30.60 | 4.09x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 11 | $247.28 | $22.48 | 3.11x |
This provider submits charges 1.8 times higher than what Medicare actually pays.
A markup ratio of 1.8x means for every $100 Medicare pays, this provider initially charges $180. 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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