De LA Pena Eye Clinic, a Medical Group, INC.
De LA Pena Eye Clinic, a Medical Group, INC. was paid $18.75M by Medicaid between Jan 2018 and Nov 2024, across 44 billing codes. Its largest line is 67028, Intravitreal injection of a pharmacologic agent — 21% of everything it billed.
33Billing provider infoDE LA PENA EYE CLINIC, A MEDICAL GROUP, INC.
MONTEBELLO, CA 90640
MONTEBELLO, CA 90640
33aNPI1114931052assigned 07/28/2006
33bProvider typeOptometrist
28Total paid$18.75M
24GClaims596,392
24DCodes billed44
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Optometrist providers in California
Rank by total paid#2 of 1,899
Median peer was paid$23K
This provider vs. median831×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official KELLY, MARK controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 55,985 | $1.24M | |
| 2019 | 71,747 | $2.09M | |
| 2020 | 50,766 | $1.57M | |
| 2021 | 89,155 | $2.63M | |
| 2022 | 124,887 | $3.89M | |
| 2023 | 111,221 | $4.16M | |
| 2024incomplete | 92,631 | $3.17M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 67028 | Intravitreal injection of a pharmacologic agent | 21% | 22,529 | 21,076 | $3.90M |
| 66984 | Extracapsular cataract removal with insertion of intraocular lens prosthesis | 17% | 6,331 | 5,364 | $3.14M |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | 10% | 76,999 | 75,136 | $1.94M |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 7.1% | 45,214 | 45,160 | $1.33M |
| J9035 | Injection, bevacizumab, 10 mg | 6.7% | 16,867 | 15,869 | $1.26M |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 5.8% | 42,252 | 42,136 | $1.09M |
| 92134 | 4.4% | 65,406 | 53,311 | $832K | |
| V2020 | Frames, purchases | 4.0% | 54,089 | 54,004 | $750K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 3.3% | 13,030 | 13,022 | $613K |
| 92133 | 3.0% | 33,813 | 29,740 | $563K | |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | 2.7% | 39,434 | 39,376 | $508K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 2.2% | 13,511 | 13,103 | $407K |
32 more codes
| 92083 | 2.1% | 23,234 | $402K | |
| 92015 | Determination of refractive state | 1.9% | 72,002 | $362K |
| 92341 | 1.3% | 12,967 | $241K | |
| 92226 | <1% | 6,414 | $184K | |
| 92250 | <1% | 7,258 | $158K | |
| 68761 | <1% | 1,413 | $125K | |
| 92202 | <1% | 12,594 | $111K | |
| 67210 | <1% | 374 | $94K | |
| 67228 | <1% | 441 | $84K | |
| 66761 | <1% | 558 | $82K | |
| 92201 | <1% | 5,943 | $78K | |
| J7999 | Compounded drug, not otherwise classified | <1% | 3,264 | $74K |
| 76519 | <1% | 2,020 | $56K | |
| 92225 | <1% | 1,548 | $52K | |
| 92136 | <1% | 1,355 | $51K | |
| 92020 | <1% | 4,262 | $46K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 2,281 | $44K |
| 76514 | <1% | 5,081 | $30K | |
| 99213 | Doctor's office visit, returning patient (routine) | <1% | 1,100 | $25K |
| 67145 | <1% | 80 | $23K | |
| 92025 | <1% | 1,381 | $23K | |
| 66982 | <1% | 32 | $22K | |
| V2203 | Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | <1% | 509 | $20K |
| 65855 | <1% | 120 | $15K | |
| 92235 | <1% | 231 | $14K | |
| 76512 | <1% | 202 | $5K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 24 | $1K |
| 99243 | <1% | 147 | $1K | |
| V2784 | Lens, polycarbonate or equal, any index, per lens | <1% | 14 | $384.00 |
| V2744 | Tint, photochromatic, per lens | <1% | 12 | $292.74 |
| 92285 | <1% | 31 | $271.19 | |
| 99422 | <1% | 25 | $155.20 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialKELLY, MARK (MEMBER, BOARD OF MANAGERS)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.