John P Downer, Od, INC.
John P Downer, Od, INC. was paid $627K by Medicaid between Jan 2018 and Jan 2024, across 13 billing codes. Its largest line is 92014, Ophthalmological services: medical examination and evaluation, comprehensive, established patient — 27% of everything it billed.
33Billing provider infoJOHN P DOWNER, OD, INC.
SPRINGFIELD, OH 45503
SPRINGFIELD, OH 45503
33aNPI1346429784assigned 11/02/2007
33bProvider typeOptometrist
28Total paid$627K
24GClaims26,893
24DCodes billed13
24AFirst – last monthJan 2018 – Jan 2024
Compared with peers
Next to other Optometrist providers in Ohio
Rank by total paid#51 of 1,098
Median peer was paid$41K
This provider vs. median15×
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 | 8,026 | $203K | |
| 2019 | 8,980 | $223K | |
| 2020 | 2,721 | $62K | |
| 2021 | 2,780 | $59K | |
| 2022 | 2,792 | $61K | |
| 2023 | 1,582 | $19K | |
| 2024incomplete | 12 | $60.00 |
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 | 27% | 4,345 | 4,030 | $172K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 25% | 3,724 | 3,471 | $160K |
| 92015 | Determination of refractive state | 19% | 9,201 | 8,622 | $122K |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | 18% | 5,640 | 5,347 | $113K |
| 92341 | 4.2% | 1,149 | 1,075 | $26K | |
| V2020 | Frames, purchases | 2.7% | 1,218 | 1,125 | $17K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 183 | 167 | $5K |
| V2784 | Lens, polycarbonate or equal, any index, per lens | <1% | 993 | 916 | $5K |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | <1% | 357 | 317 | $4K |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | <1% | 44 | 42 | $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% | 14 | 12 | $413.35 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 13 | 12 | $240.57 |
1 more codes
| V2203 | Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | <1% | 12 | $208.00 |
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 officialDOWNER, JOHN (OWNER/OPTOMETRIST)