Balfour, Walter
Balfour, Walter was paid $600K by Medicaid between Jan 2018 and Jan 2024, across 9 billing codes. Its largest line is 92004, Ophthalmological services: medical examination and evaluation, comprehensive, new patient — 34% of everything it billed.
33Billing provider infoBALFOUR, WALTER
GALLUP, NM 87301
GALLUP, NM 87301
33aNPI1083770119assigned 01/01/2007
33bProvider typeOptometrist
28Total paid$600K
24GClaims13,812
24DCodes billed9
24AFirst – last monthJan 2018 – Jan 2024
Compared with peers
Next to other Optometrist providers in New Mexico
Rank by total paid#28 of 122
Median peer was paid$112K
This provider vs. median5.4×
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 | 3,578 | $160K | |
| 2019 | 4,199 | $172K | |
| 2020 | 1,819 | $79K | |
| 2021 | 1,371 | $63K | |
| 2022 | 1,363 | $54K | |
| 2023 | 1,399 | $69K | |
| 2024incomplete | 83 | $3K |
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 | 34% | 2,072 | 2,037 | $204K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 27% | 1,905 | 1,873 | $161K |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | 21% | 3,403 | 3,339 | $123K |
| V2020 | Frames, purchases | 11% | 3,440 | 3,377 | $65K |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 3.6% | 1,793 | 1,782 | $21K |
| V2106 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens | 2.5% | 303 | 283 | $15K |
| V2105 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens | 1.1% | 424 | 420 | $7K |
| 92015 | Determination of refractive state | <1% | 446 | 419 | $3K |
| V2104 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens | <1% | 26 | 26 | $325.12 |
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.