Physician
Simon, John
Simon, John was paid $128K by Medicaid between Jan 2018 and Mar 2024, across 6 billing codes. Its largest line is 92014, Ophthalmological services: medical examination and evaluation, comprehensive, established patient — 76% of everything it billed.
33Billing provider infoSIMON, JOHN
LATHAM, NY 12110
LATHAM, NY 12110
33aNPI1093770323assigned 04/19/2006
33bProvider typeOphthalmology Physician
28Total paid$128K
24GClaims2,354
24DCodes billed6
24AFirst – last monthJan 2018 – Mar 2024
Compared with peers
Next to other Ophthalmology Physician providers in New York
Rank by total paid#357 of 1,085
Median peer was paid$34K
This provider vs. median3.8×
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 | 460 | $33K | |
| 2019 | 565 | $35K | |
| 2020 | 368 | $20K | |
| 2021 | 603 | $23K | |
| 2022 | 180 | $11K | |
| 2023 | 150 | $5K | |
| 2024incomplete | 28 | $753.30 |
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 | 76% | 1,016 | 1,015 | $97K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 9.9% | 99 | 99 | $13K |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | 7.0% | 124 | 122 | $9K |
| 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% | 101 | 101 | $7K |
| 92015 | Determination of refractive state | 1.3% | 747 | 745 | $2K |
| 99072 | 0% | 267 | 267 | $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.