Sparks, Estel
Sparks, Estel was paid $67K by Medicaid between Jan 2018 and Apr 2024, across 6 billing codes. Its largest line is 92004, Ophthalmological services: medical examination and evaluation, comprehensive, new patient — 43% of everything it billed.
33Billing provider infoSPARKS, ESTEL
SPRING CITY, TN 37381
SPRING CITY, TN 37381
33aNPI1265418537assigned 12/19/2005
33bProvider typeOptometrist
28Total paid$67K
24GClaims1,687
24DCodes billed6
24AFirst – last monthJan 2018 – Apr 2024
Compared with peers
Next to other Optometrist providers in Tennessee
Rank by total paid#226 of 698
Median peer was paid$19K
This provider vs. median3.5×
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 | 543 | $19K | |
| 2019 | 347 | $16K | |
| 2020 | 179 | $9K | |
| 2021 | 188 | $8K | |
| 2022 | 268 | $10K | |
| 2023 | 135 | $4K | |
| 2024incomplete | 27 | $939.10 |
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 | 43% | 593 | 579 | $29K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 33% | 458 | 457 | $22K |
| 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 | 12% | 384 | 364 | $8K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 11% | 178 | 161 | $7K |
| 92015 | Determination of refractive state | <1% | 57 | 57 | $598.00 |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | <1% | 17 | 17 | $342.90 |
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.