Simon, Melissa

Simon, Melissa was paid $490K by Medicaid between Jan 2018 and Dec 2024, across 9 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 40% of everything it billed.

33Billing provider infoSIMON, MELISSA
PROVIDENCE, RI 02903

33aNPI1316265259assigned 05/16/2010

33bProvider typeOphthalmology Physician

28Total paid$490K

24GClaims5,789

24DCodes billed9

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Ophthalmology Physician providers in Rhode Island

Rank by total paid#4 of 31

Median peer was paid$22K

This provider vs. median22×

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	1,113	$93K
2019	162	$4K
2020	427	$30K
2021	1,182	$90K
2022	1,055	$99K
2023	989	$91K
2024incomplete	861	$84K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
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	40%	1,651	1,565	$197K
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	25%	665	635	$124K
92060		20%	1,310	1,258	$96K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	6.6%	388	375	$33K
92015	Determination of refractive state	6.5%	1,601	1,501	$32K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	90	81	$4K
92133		<1%	58	56	$2K
92250		<1%	14	14	$1K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	<1%	12	12	$1K

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.