Physician
Donahue, Sean
Donahue, Sean was paid $157K by Medicaid between Jan 2018 and Nov 2020, across 13 billing codes. Its largest line is 92012, Ophthalmological services: medical examination and evaluation, intermediate, established patient — 22% of everything it billed.
33Billing provider infoDONAHUE, SEAN
NASHVILLE, TN 37232
NASHVILLE, TN 37232
33aNPI1083706402assigned 09/30/2006
33bProvider typeOphthalmology Physician
28Total paid$157K
24GClaims3,112
24DCodes billed13
24AFirst – last monthJan 2018 – Nov 2020
Compared with peers
Next to other Ophthalmology Physician providers in Tennessee
Rank by total paid#28 of 114
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 | 1,515 | $83K | |
| 2019 | 795 | $42K | |
| 2020 | 802 | $32K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | 22% | 679 | 623 | $35K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 20% | 411 | 390 | $32K |
| 99243 | 15% | 223 | 218 | $24K | |
| 92060 | 9.3% | 434 | 393 | $15K | |
| 92015 | Determination of refractive state | 9.1% | 815 | 786 | $14K |
| 67311 | 5.4% | 12 | 12 | $8K | |
| 92226 | 5.1% | 134 | 74 | $8K | |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 4.6% | 91 | 87 | $7K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 4.4% | 69 | 62 | $7K |
| 92201 | 2.9% | 176 | 142 | $4K | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 32 | 31 | $1K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | <1% | 14 | 12 | $1K |
1 more codes
| 92225 | <1% | 22 | $515.60 |
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.