Kaplan, Seth

Kaplan, Seth was paid $4K by Medicaid between Jun 2021 and Mar 2024, across 3 billing codes. Its largest line is 92014, Ophthalmological services: medical examination and evaluation, comprehensive, established patient — 89% of everything it billed.

33Billing provider infoKAPLAN, SETH
BLUE ISLAND, IL 60406

33aNPI1548224454assigned 04/17/2006

33bProvider typeOphthalmology Physician

28Total paid$4K

24GClaims182

24DCodes billed3

24AFirst – last monthJun 2021 – Mar 2024

Compared with peers

Next to other Ophthalmology Physician providers in Illinois

Rank by total paid#331 of 431

Median peer was paid$34K

This provider vs. median0.1×

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
2021	14	$126.59
2022	71	$2K
2023	84	$2K
2024incomplete	13	$326.92

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	89%	155	155	$4K
92004	Ophthalmological services: medical examination and evaluation, comprehensive, new patient	7.8%	13	13	$343.29
92012	Ophthalmological services: medical examination and evaluation, intermediate, established patient	2.9%	14	12	$126.59

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.