Physician
James S. Rosenthal, MD PC
James S. Rosenthal, MD PC was paid $521K by Medicaid between Jan 2018 and Oct 2021, across 10 billing codes. Its largest line is 92014, Ophthalmological services: medical examination and evaluation, comprehensive, established patient — 53% of everything it billed.
33Billing provider infoJAMES S. ROSENTHAL, MD PC
SPRINGFIELD, MA 01107
SPRINGFIELD, MA 01107
33aNPI1316132517assigned 09/11/2007
33bProvider typeOphthalmology Physician
28Total paid$521K
24GClaims13,928
24DCodes billed10
24AFirst – last monthJan 2018 – Oct 2021
Compared with peers
Next to other Ophthalmology Physician providers in Massachusetts
Rank by total paid#19 of 203
Median peer was paid$18K
This provider vs. median29×
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 | 4,258 | $150K | |
| 2019 | 4,300 | $161K | |
| 2020 | 2,816 | $96K | |
| 2021 | 2,554 | $114K |
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 | 53% | 3,131 | 3,030 | $276K |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | 15% | 1,285 | 1,195 | $77K |
| 92083 | 9.6% | 1,212 | 991 | $50K | |
| 92015 | Determination of refractive state | 8.9% | 3,642 | 3,545 | $47K |
| 92133 | 7.0% | 1,261 | 793 | $36K | |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 6.6% | 357 | 355 | $34K |
| 2022F | <1% | 1,348 | 1,305 | $174.22 | |
| G8397 | Dilated macular or fundus exam performed, including documentation of the presence or absence of macular edema and level of severity of retinopathy | 0% | 14 | 14 | $0.00 |
| 2027F | 0% | 1,664 | 1,530 | $0.00 | |
| 5010F | 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.
From NPPES
Who's on the registration
Authorized officialROSENTHAL, JAMES (PRESIDENT)