Mcfadden, Donald
Mcfadden, Donald was paid $318K by Medicaid between Jan 2018 and Aug 2024, across 12 billing codes. Its largest line is 92014, Ophthalmological services: medical examination and evaluation, comprehensive, established patient — 57% of everything it billed.
33Billing provider infoMCFADDEN, DONALD
FLORENCE, KY 41042
FLORENCE, KY 41042
33aNPI1356722441assigned 06/15/2015
33bProvider typeOptometrist
28Total paid$318K
24GClaims10,167
24DCodes billed12
24AFirst – last monthJan 2018 – Aug 2024
Compared with peers
Next to other Optometrist providers in Kentucky
Rank by total paid#174 of 683
Median peer was paid$123K
This provider vs. median2.6×
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 | 4,152 | $108K | |
| 2019 | 4,427 | $119K | |
| 2020 | 790 | $38K | |
| 2022 | 15 | $1K | |
| 2023 | 478 | $32K | |
| 2024incomplete | 305 | $20K |
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 | 57% | 3,710 | 3,547 | $181K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 15% | 1,337 | 1,281 | $49K |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 9.5% | 1,416 | 1,370 | $30K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 7.1% | 731 | 569 | $22K |
| V2020 | Frames, purchases | 3.5% | 1,391 | 1,343 | $11K |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 2.8% | 713 | 707 | $9K |
| 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 | 2.3% | 300 | 249 | $7K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.1% | 195 | 164 | $7K |
| 92250 | <1% | 17 | 14 | $520.18 | |
| 92285 | <1% | 136 | 98 | $501.42 | |
| 92083 | <1% | 20 | 13 | $400.00 | |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | 0% | 201 | 192 | $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.