Grady D. Gafford MD PC
Grady D. Gafford MD PC was paid $684K by Medicaid between Jan 2018 and Dec 2024, across 24 billing codes. Its largest line is V2100, Sphere, single vision, plano to plus or minus 4.00, per lens — 23% of everything it billed.
33Billing provider infoGRADY D. GAFFORD MD PC
WELLSBORO, PA 16901
WELLSBORO, PA 16901
33aNPI1184635286assigned 08/11/2006
33bProvider typeOptometrist
28Total paid$684K
24GClaims25,502
24DCodes billed24
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Optometrist providers in Pennsylvania
Rank by total paid#29 of 983
Median peer was paid$20K
This provider vs. median34×
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 | 323 | $1K | |
| 2019 | 955 | $24K | |
| 2020 | 709 | $22K | |
| 2021 | 6,326 | $176K | |
| 2022 | 6,337 | $180K | |
| 2023 | 6,195 | $168K | |
| 2024incomplete | 4,657 | $112K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 23% | 5,745 | 2,804 | $156K |
| V2020 | Frames, purchases | 22% | 3,836 | 3,522 | $153K |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | 18% | 3,396 | 3,327 | $126K |
| 92002 | 11% | 1,952 | 1,920 | $76K | |
| 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 | 6.8% | 1,132 | 1,127 | $47K |
| 92134 | 4.6% | 1,162 | 1,153 | $31K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 3.2% | 798 | 700 | $22K |
| 92083 | 3.0% | 381 | 380 | $21K | |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 2.3% | 4,286 | 1,985 | $16K |
| 92015 | Determination of refractive state | 1.2% | 1,578 | 1,564 | $8K |
| V2200 | Sphere, bifocal, plano to plus or minus 4.00d, per lens | 1.0% | 187 | 101 | $7K |
| V2744 | Tint, photochromatic, per lens | <1% | 228 | 113 | $7K |
12 more codes
| V2750 | Anti-reflective coating, per lens | <1% | 232 | $4K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | <1% | 235 | $4K |
| V2781 | Progressive lens, per lens | <1% | 58 | $2K |
| V2299 | Specialty bifocal (by report) | <1% | 58 | $2K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | <1% | 38 | $2K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 12 | $894.66 |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | <1% | 30 | $802.20 |
| V2760 | Scratch resistant coating, per lens | <1% | 50 | $445.00 |
| 2022F | 0% | 12 | $0.00 | |
| G8731 | Pain assessment using a standardized tool is documented as negative, no follow-up plan required | 0% | 35 | $0.00 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 32 | $0.00 |
| 1036F | 0% | 29 | $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 officialSTRAHOTA, COLLEEN (ADMINISTRATOR)