Setork, Sheila
Setork, Sheila was paid $105K by Medicaid between May 2020 and Dec 2024, across 8 billing codes. Its largest line is 92014, Ophthalmological services: medical examination and evaluation, comprehensive, established patient — 22% of everything it billed.
33Billing provider infoSETORK, SHEILA
SKOKIE, IL 60077
SKOKIE, IL 60077
33aNPI1679854160assigned 08/29/2011
33bProvider typeOptometrist
28Total paid$105K
24GClaims3,645
24DCodes billed8
24AFirst – last monthMay 2020 – Dec 2024
Compared with peers
Next to other Optometrist providers in Illinois
Rank by total paid#402 of 1,069
Median peer was paid$56K
This provider vs. median1.9×
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 | |
|---|---|---|---|
| 2020 | 500 | $21K | |
| 2021 | 574 | $24K | |
| 2022 | 612 | $14K | |
| 2023 | 969 | $22K | |
| 2024incomplete | 990 | $24K |
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 | 22% | 571 | 557 | $23K |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | 21% | 491 | 479 | $22K |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 20% | 565 | 540 | $21K |
| V2020 | Frames, purchases | 16% | 599 | 574 | $16K |
| 92015 | Determination of refractive state | 7.1% | 736 | 725 | $7K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 5.8% | 146 | 144 | $6K |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | 5.0% | 259 | 245 | $5K |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 3.4% | 278 | 260 | $4K |
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.