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PACIFIC EYE INSTITUTE, A MEDICAL GROUP, INC.

Ophthalmology·UPLAND, CA·NPI: 1962422709Share
Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$21.1M

$21,051,708

Total Claims

232K

Beneficiaries

210K

1.1 claims/patient

Avg Cost/Claim

$91

Monthly Spending Trend

Yearly Spending

2018
$1.7M
+28%
2019
$2.2M
+2%
2020
$2.3M
+18%
2021
$2.7M
+12%
2022
$3.0M
+57%
2023
$4.7M
-4%
2024
$4.5M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 46 distinct procedure codes. The top code (67028 (Intravitreal injection of a pharmacologic agent)) accounts for 26% of total spending.

67028Top 5%

Intravitreal injection of a pharmacologic agent

$5.5M

20K claims · 25.9%

Your Cost: $269.34/claim|Median: $58.82
4.6× median
66984Top 25%

Extracapsular cataract removal with IOL insertion

$5.0M

7,211 claims · 23.7%

Your Cost: $691.47/claim|Median: $268.70
2.6× median
J0178Normal range

Injection, aflibercept, 1 mg

$3.4M

3,131 claims · 16.0%

Your Cost: $1,078.71/claim|Median: $730.09
1.5× median
92014Normal range

Ophthalmological exam, comprehensive, established patient

$1.5M

46K claims · 7.0%

Your Cost: $32.46/claim|Median: $47.08
0.7× median
92012Normal range

Ophthalmological exam, intermediate, established patient

$1.1M

39K claims · 5.4%

Your Cost: $28.70/claim|Median: $38.23
0.8× median
J9035Normal range

Injection, bevacizumab, 10 mg

$983K

18K claims · 4.7%

Your Cost: $55.37/claim|Median: $43.71
1.3× median
92134Normal range

$881K

40K claims · 4.2%

Your Cost: $22.29/claim|Median: $15.46
1.4× median
66821Top 25%

$461K

2,872 claims · 2.2%

Your Cost: $160.53/claim|Median: $83.06
1.9× median
92004Normal range

Ophthalmological exam, comprehensive, new patient

$324K

7,495 claims · 1.5%

Your Cost: $43.29/claim|Median: $59.72
0.7× median
66982Top 25%

$324K

415 claims · 1.5%

Your Cost: $780.74/claim|Median: $375.52
2.1× median
J2777Top 25%

$258K

212 claims · 1.2%

Your Cost: $1,218.26/claim|Median: $858.80
1.4× median
92083Normal range

Visual field exam, extended testing, bilateral

$195K

8,933 claims · 0.9%

Your Cost: $21.83/claim|Median: $29.82
0.7× median
99204Normal range

Office/outpatient visit, new patient, mod-high complexity

$192K

2,919 claims · 0.9%

Your Cost: $65.68/claim|Median: $84.03
0.8× median
92136Top 25%

$164K

4,495 claims · 0.8%

Your Cost: $36.50/claim|Median: $18.31
2.0× median
92133Normal range

$157K

7,125 claims · 0.7%

Your Cost: $22.02/claim|Median: $19.09
1.2× median
67228Normal range

$125K

537 claims · 0.6%

Your Cost: $233.30/claim|Median: $256.67
0.9× median
68761Normal range

$107K

1,544 claims · 0.5%

Your Cost: $69.44/claim|Median: $60.32
1.2× median
99214Normal range

Office/outpatient visit, est. patient, mod-high complexity

$94K

2,856 claims · 0.4%

Your Cost: $32.87/claim|Median: $53.41
0.6× median
65426Normal range

$64K

83 claims · 0.3%

Your Cost: $769.50/claim|Median: $578.99
1.3× median
V2632Normal range

$63K

945 claims · 0.3%

Your Cost: $66.71/claim|Median: $22.85
2.9× median
92250Normal range

Fundus photography with interpretation and report

$56K

1,871 claims · 0.3%

Your Cost: $30.13/claim|Median: $27.95
1.1× median
92025Normal range

$42K

2,126 claims · 0.2%

Your Cost: $19.79/claim|Median: $17.08
1.2× median
92235Normal range

$35K

551 claims · 0.2%

Your Cost: $63.74/claim|Median: $42.71
1.5× median
92020Normal range

$21K

1,524 claims · 0.1%

Your Cost: $13.66/claim|Median: $12.46
1.1× median
92226Top 5%

$20K

358 claims · 0.1%

Your Cost: $56.60/claim|Median: $12.45
4.5× median
99213Normal range

Office/outpatient visit, est. patient, low-mod complexity

$14K

877 claims · 0.1%

Your Cost: $16.20/claim|Median: $37.81
0.4× median
92225Top 5%

$13K

200 claims · 0.1%

Your Cost: $65.38/claim|Median: $17.59
3.7× median
99203Normal range

Office/outpatient visit, new patient, low-mod complexity

$4K

70 claims · 0.0%

Your Cost: $60.47/claim|Median: $57.85
1.0× median
92275Normal range

$4K

134 claims · 0.0%

Your Cost: $31.34/claim|Median: $45.77
0.7× median
92002Normal range

Intermediate eye exam, new patient

$4K

111 claims · 0.0%

Your Cost: $36.29/claim|Median: $41.61
0.9× median
99212Normal range

Office/outpatient visit, low complexity

$4K

232 claims · 0.0%

Your Cost: $16.77/claim|Median: $25.06
0.7× median
76514Normal range

$3K

437 claims · 0.0%

Your Cost: $6.60/claim|Median: $6.67
1.0× median
J7312Normal range

$3K

25 claims · 0.0%

Your Cost: $107.71/claim|Median: $710.09
0.2× median
92201Normal range

$2K

240 claims · 0.0%

Your Cost: $9.71/claim|Median: $12.88
0.8× median
99205Normal range

Office/outpatient visit, new patient, high complexity

$2K

25 claims · 0.0%

Your Cost: $79.98/claim|Median: $111.09
0.7× median
65855Normal range

$1K

15 claims · 0.0%

Your Cost: $82.28/claim|Median: $104.20
0.8× median
76512Normal range

$761

14 claims · 0.0%

Your Cost: $54.36/claim|Median: $43.41
1.3× median
83861Normal range

$706

48 claims · 0.0%

Your Cost: $14.70/claim|Median: $10.95
1.3× median
92081Top 25%

$533

20 claims · 0.0%

Your Cost: $26.67/claim|Median: $11.63
2.3× median
J7050Normal range

Normal saline solution infusion, 250 cc

$410

651 claims · 0.0%

Your Cost: $0.63/claim|Median: $0.82
0.8× median
92202Normal range

$112

16 claims · 0.0%

Your Cost: $6.99/claim|Median: $7.06
1.0× median
99024Normal range

$0

398 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.15
3072FNormal range

$0

13 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.71
2022FNormal range

$0

20 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.07
J7030Normal range

Normal saline solution infusion, 1000 cc

$0

352 claims · 0.0%

Your Cost: $0.00/claim|Median: $1.53
0360Normal range

$0

8,418 claims · 0.0%

Your Cost: $0.00/claim|Median: $95.40

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