Gustafson, Thomas
Gustafson, Thomas was paid $12K by Medicaid between Jun 2018 and Oct 2024, across 7 billing codes. Its largest line is 92015, Determination of refractive state — 41% of everything it billed.
33Billing provider infoGUSTAFSON, THOMAS
PALATINE, IL 60067
PALATINE, IL 60067
33aNPI1164492096assigned 01/24/2006
33bProvider typeOptometrist
28Total paid$12K
24GClaims802
24DCodes billed7
24AFirst – last monthJun 2018 – Oct 2024
Compared with peers
Next to other Optometrist providers in Illinois
Rank by total paid#786 of 1,069
Median peer was paid$56K
This provider vs. median0.2×
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 | 82 | $450.00 | |
| 2019 | 201 | $2K | |
| 2020 | 129 | $3K | |
| 2021 | 235 | $4K | |
| 2022 | 60 | $287.36 | |
| 2023 | 36 | $646.56 | |
| 2024incomplete | 59 | $1K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 92015 | Determination of refractive state | 41% | 264 | 264 | $5K |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | 27% | 71 | 60 | $3K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 17% | 392 | 392 | $2K |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 12% | 22 | 13 | $1K |
| V2025 | Deluxe frame | 2.0% | 21 | 12 | $226.80 |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 1.2% | 18 | 18 | $135.00 |
| 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 | 0% | 14 | 14 | $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.