Edelstein, Michael
Edelstein, Michael was paid $161K by Medicaid between Jan 2018 and Nov 2024, across 7 billing codes. Its largest line is 92340, Fitting of spectacles, except for aphakia; monofocal — 39% of everything it billed.
33Billing provider infoEDELSTEIN, MICHAEL
WALTHAM, MA 02453
WALTHAM, MA 02453
33aNPI1043296213assigned 12/20/2005
33bProvider typeOptometrist
28Total paid$161K
24GClaims6,097
24DCodes billed7
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Optometrist providers in Massachusetts
Rank by total paid#112 of 629
Median peer was paid$15K
This provider vs. median11×
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 | 856 | $23K | |
| 2019 | 774 | $19K | |
| 2020 | 616 | $15K | |
| 2021 | 662 | $18K | |
| 2022 | 769 | $19K | |
| 2023 | 1,316 | $34K | |
| 2024incomplete | 1,104 | $33K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 92340 | Fitting of spectacles, except for aphakia; monofocal | 39% | 2,188 | 1,984 | $63K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 31% | 1,261 | 1,204 | $51K |
| 92015 | Determination of refractive state | 16% | 2,197 | 2,096 | $25K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 11% | 295 | 266 | $17K |
| 92341 | 2.8% | 128 | 119 | $4K | |
| G8732 | No documentation of pain assessment, reason not given | 0% | 14 | 14 | $0.00 |
| G8428 | Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given | 0% | 14 | 14 | $0.00 |
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.