Cecil, James
Cecil, James was paid $299K by Medicaid between Jan 2018 and Nov 2022, across 11 billing codes. Its largest line is 92004, Ophthalmological services: medical examination and evaluation, comprehensive, new patient — 58% of everything it billed.
33Billing provider infoCECIL, JAMES
PIKEVILLE, KY 41501
PIKEVILLE, KY 41501
33aNPI1053354571assigned 06/13/2006
33bProvider typeOptometrist
28Total paid$299K
24GClaims8,580
24DCodes billed11
24AFirst – last monthJan 2018 – Nov 2022
Compared with peers
Next to other Optometrist providers in Kentucky
Rank by total paid#188 of 683
Median peer was paid$123K
This provider vs. median2.4×
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 | 2,216 | $78K | |
| 2019 | 1,461 | $58K | |
| 2020 | 2,221 | $78K | |
| 2021 | 2,033 | $69K | |
| 2022 | 649 | $17K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 58% | 2,211 | 2,055 | $175K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 33% | 1,656 | 1,565 | $100K |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | 2.5% | 234 | 233 | $8K |
| V2020 | Frames, purchases | 2.5% | 252 | 251 | $7K |
| 92015 | Determination of refractive state | 1.3% | 3,497 | 3,270 | $4K |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | <1% | 158 | 130 | $3K |
| V2784 | Lens, polycarbonate or equal, any index, per lens | <1% | 298 | 225 | $2K |
| 92250 | <1% | 15 | 13 | $518.06 | |
| V2760 | Scratch resistant coating, per lens | <1% | 163 | 163 | $312.20 |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | <1% | 22 | 18 | $300.00 |
| G8428 | Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given | 0% | 74 | 50 | $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.