Physician
Optima Ophthalmic Medical Associates, INC
Optima Ophthalmic Medical Associates, INC was paid $1.67M by Medicaid between Jan 2018 and Nov 2024, across 24 billing codes. Its largest line is J0178, Injection, aflibercept, 1 mg — 24% of everything it billed.
33Billing provider infoOPTIMA OPHTHALMIC MEDICAL ASSOCIATES, INC
HAYWARD, CA 94541
HAYWARD, CA 94541
33aNPI1285837484assigned 06/06/2007
33bProvider typeOphthalmology Physician
28Total paid$1.67M
24GClaims31,578
24DCodes billed24
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Ophthalmology Physician providers in California
Rank by total paid#62 of 759
Median peer was paid$35K
This provider vs. median47×
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.
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 | 5,028 | $208K | |
| 2019 | 5,011 | $230K | |
| 2020 | 3,445 | $135K | |
| 2021 | 4,075 | $237K | |
| 2022 | 4,079 | $254K | |
| 2023 | 4,709 | $290K | |
| 2024incomplete | 5,231 | $322K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 24% | 588 | 557 | $396K |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | 20% | 8,047 | 7,446 | $338K |
| 67028 | Intravitreal injection of a pharmacologic agent | 10% | 3,210 | 2,757 | $168K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 9.7% | 2,788 | 2,770 | $163K |
| 66984 | Extracapsular cataract removal with insertion of intraocular lens prosthesis | 8.1% | 617 | 498 | $136K |
| 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 | 6.6% | 1,241 | 1,239 | $110K |
| 92134 | 5.7% | 5,725 | 5,539 | $96K | |
| J9035 | Injection, bevacizumab, 10 mg | 4.8% | 1,342 | 1,136 | $80K |
| 92083 | 2.6% | 2,368 | 1,479 | $44K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 2.1% | 887 | 835 | $34K |
| 67228 | 1.6% | 170 | 122 | $27K | |
| 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 | 1.1% | 359 | 347 | $18K |
12 more codes
| 92133 | 1.1% | 1,037 | $18K | |
| 92136 | <1% | 871 | $14K | |
| 92226 | <1% | 666 | $7K | |
| 92250 | <1% | 452 | $7K | |
| 92235 | <1% | 139 | $6K | |
| 92015 | Determination of refractive state | <1% | 457 | $5K |
| 92025 | <1% | 218 | $4K | |
| 92225 | <1% | 153 | $2K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 27 | $853.87 |
| 92202 | <1% | 79 | $678.82 | |
| J7999 | Compounded drug, not otherwise classified | <1% | 85 | $180.42 |
| 76514 | <1% | 52 | $180.01 |
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 officialMANDEL, MARK (SECRETARY TREASURER)
| Provider | Location | Paid |
|---|---|---|
| Optima Ophthalmic Medical Associates INC | Hayward, CA | $801K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.