Swanholm, Anthony
Swanholm, Anthony was paid $14K by Medicaid between Feb 2018 and Jun 2022, across 8 billing codes. Its largest line is 99204, doctor's office visit, new patient (more involved) — 66% of everything it billed.
33Billing provider infoSWANHOLM, ANTHONY
COVINGTON, KY 41011
COVINGTON, KY 41011
33aNPI1609228089assigned 07/08/2016
33bProvider typeOptometrist
28Total paid$14K
24GClaims314
24DCodes billed8
24AFirst – last monthFeb 2018 – Jun 2022
Compared with peers
Next to other Optometrist providers in Kentucky
Rank by total paid#554 of 683
Median peer was paid$123K
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 | |
|---|---|---|---|
| 2018 | 164 | $4K | |
| 2020 | 13 | $711.36 | |
| 2021 | 121 | $8K | |
| 2022 | 16 | $1K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 66% | 137 | 100 | $9K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 12% | 18 | 18 | $2K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 7.1% | 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 | 5.0% | 13 | 12 | $711.36 |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | 3.1% | 13 | 13 | $445.50 |
| V2020 | Frames, purchases | 2.9% | 15 | 15 | $408.75 |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 2.2% | 22 | 12 | $319.30 |
| 92015 | Determination of refractive state | 2.0% | 82 | 81 | $283.08 |
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.