Simon, Mark

Simon, Mark was paid $12K by Medicaid between Feb 2018 and Jun 2021, across 6 billing codes. Its largest line is 66984, Extracapsular cataract removal with insertion of intraocular lens prosthesis — 56% of everything it billed.

33Billing provider infoSIMON, MARK
WINCHESTER, KY 40391

33aNPI1538110572assigned 05/15/2006

33bProvider typeOphthalmology Physician

28Total paid$12K

24GClaims180

24DCodes billed6

24AFirst – last monthFeb 2018 – Jun 2021

Compared with peers

Next to other Ophthalmology Physician providers in Kentucky

Rank by total paid#62 of 110

Median peer was paid$15K

This provider vs. median0.7×

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	124	$10K
2019	27	$915.76
2020	15	$426.30
2021	14	$356.95

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
66984	Extracapsular cataract removal with insertion of intraocular lens prosthesis	56%	21	14	$7K
92136		15%	60	54	$2K
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%	13	12	$1K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	7.8%	29	27	$896.49
92015	Determination of refractive state	5.8%	44	42	$667.26
92250		3.9%	13	13	$445.57

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.