Derby, Jack
Derby, Jack was paid $5K by Medicaid between Jun 2018 and Jun 2023, across 4 billing codes. Its largest line is 92014, Ophthalmological services: medical examination and evaluation, comprehensive, established patient — 32% of everything it billed.
33Billing provider infoDERBY, JACK
MARION, IN 46953
MARION, IN 46953
33aNPI1841671948assigned 06/15/2015
33bProvider typeOptometrist
28Total paid$5K
24GClaims210
24DCodes billed4
24AFirst – last monthJun 2018 – Jun 2023
Compared with peers
Next to other Optometrist providers in Indiana
Rank by total paid#496 of 743
Median peer was paid$22K
This provider vs. median0.2×
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 | 140 | $4K | |
| 2019 | 42 | $1K | |
| 2023 | 28 | $228.84 |
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 | 32% | 23 | 21 | $2K |
| 92015 | Determination of refractive state | 28% | 123 | 117 | $2K |
| V2020 | Frames, purchases | 26% | 48 | 46 | $1K |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 14% | 16 | 15 | $755.16 |
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.