Physician
Pratt Ophthalmology Associates INC
Pratt Ophthalmology Associates INC was paid $2.95M by Medicaid between Jan 2018 and Dec 2024, across 30 billing codes. Its largest line is 92014, Ophthalmological services: medical examination and evaluation, comprehensive, established patient — 48% of everything it billed.
33Billing provider infoPRATT OPHTHALMOLOGY ASSOCIATES INC
BOSTON, MA 02111
BOSTON, MA 02111
33aNPI1083660534assigned 05/26/2006
33bProvider typeOphthalmology Physician
28Total paid$2.95M
24GClaims110,437
24DCodes billed30
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Ophthalmology Physician providers in Massachusetts
Rank by total paid#3 of 203
Median peer was paid$18K
This provider vs. median166×
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 GALLEGOS, EDWARD 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 | 16,768 | $368K | |
| 2019 | 16,448 | $412K | |
| 2020 | 10,976 | $312K | |
| 2021 | 16,045 | $447K | |
| 2022 | 14,774 | $414K | |
| 2023 | 18,853 | $512K | |
| 2024incomplete | 16,573 | $483K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 48% | 35,729 | 35,115 | $1.40M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 7.6% | 8,195 | 7,973 | $223K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 7.1% | 2,686 | 2,633 | $209K |
| 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 | 5.8% | 5,297 | 5,096 | $169K |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | 5.0% | 6,966 | 6,689 | $147K |
| J0178 | Injection, aflibercept, 1 mg | 4.7% | 477 | 407 | $138K |
| 92134 | 4.6% | 15,291 | 14,421 | $134K | |
| 67028 | Intravitreal injection of a pharmacologic agent | 3.7% | 4,624 | 4,347 | $108K |
| 92015 | Determination of refractive state | 3.3% | 8,417 | 8,188 | $96K |
| 92083 | 2.8% | 7,349 | 6,958 | $83K | |
| 92133 | 2.7% | 8,410 | 7,968 | $79K | |
| 92060 | 2.4% | 2,572 | 2,456 | $70K |
18 more codes
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 313 | $27K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | <1% | 1,051 | $19K |
| 66984 | Extracapsular cataract removal with insertion of intraocular lens prosthesis | <1% | 117 | $13K |
| 92020 | <1% | 1,312 | $11K | |
| 92136 | <1% | 475 | $5K | |
| 92025 | <1% | 186 | $2K | |
| 88313 | <1% | 258 | $2K | |
| 88304 | <1% | 225 | $1K | |
| 88312 | <1% | 87 | $1K | |
| 92250 | <1% | 155 | $1K | |
| 99205 | Prolong outpt/office vis | <1% | 12 | $1K |
| 88342 | <1% | 45 | $974.50 | |
| 88307 | <1% | 14 | $917.28 | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 12 | $865.85 |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 12 | $637.42 |
| 76514 | <1% | 113 | $409.18 | |
| 92132 | <1% | 12 | $93.45 | |
| 92226 | 0% | 25 | $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.
From NPPES
Who's on the registration
Authorized officialGALLEGOS, EDWARD (DIRECTOR)
| Provider | Location | Paid |
|---|---|---|
| Pratt Pediatric Associates INC | Boston, MA | $7.66M |
| Pratt Ob/Gyn Associates, INC | Boston, MA | $2.62M |
| Pratt Medical Group, INC | Boston, MA | $2.18M |
| Pratt Radiology Associates, INC | Boston, MA | $1.58M |
| Pratt Pathology Associates, INC | Boston, MA | $1.47M |
| Pratt Med/Surg Dermatology Associates INC | Boston, MA | $851K |
| Cardiovascular Center at Tufts Medical Center, INC. | Boston, MA | $721K |
| Pratt Medical Group, INC | Boston, MA | $705K |
| Pratt Orthopaedic Associates, INC | Boston, MA | $566K |
| Pratt Otolaryngology- Head & Neck Surgery Associates INC | Boston, MA | $536K |
| Pratt Psychiatric Associates, INC | Boston, MA | $346K |
| Pratt Neurology Associates, INC | Boston, MA | $279K |
| Pratt Medical Group, INC | Boston, MA | $269K |
| Pratt Medical Group, INC | Boston, MA | $247K |
| Pratt Medical Group, INC | Boston, MA | $240K |
| Pratt Urology Associates, INC | Boston, MA | $204K |
| Pratt Anesthesiology Associates, INC | Boston, MA | $197K |
| Pratt Medical Group, INC | Boston, MA | $141K |
| Pratt Medical Group, INC | Boston, MA | $127K |
| Pratt Surgical Associates INC | Boston, MA | $123K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.