Legarreta, Edward
Legarreta, Edward was paid $1.14M by Medicaid between Jan 2018 and Dec 2024, across 17 billing codes. Its largest line is 92012, Ophthalmological services: medical examination and evaluation, intermediate, established patient — 31% of everything it billed.
33Billing provider infoLEGARRETA, EDWARD
WILLIAMSVILLE, NY 14221
WILLIAMSVILLE, NY 14221
33aNPI1942265988assigned 04/20/2006
33bProvider typeSpecialist
28Total paid$1.14M
24GClaims43,190
24DCodes billed17
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Specialist providers in New York
Rank by total paid#138 of 1,221
Median peer was paid$45K
This provider vs. median25×
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 | 2,746 | $64K | |
| 2019 | 4,626 | $121K | |
| 2020 | 6,377 | $172K | |
| 2021 | 7,174 | $204K | |
| 2022 | 7,964 | $210K | |
| 2023 | 8,238 | $207K | |
| 2024incomplete | 6,065 | $157K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | 31% | 6,446 | 6,070 | $354K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 20% | 4,443 | 4,428 | $229K |
| 92083 | 15% | 4,343 | 4,295 | $175K | |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 7.2% | 1,796 | 1,795 | $82K |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 6.3% | 3,585 | 1,759 | $72K |
| V2020 | Frames, purchases | 5.5% | 5,004 | 4,837 | $62K |
| 92133 | 5.4% | 2,692 | 2,673 | $62K | |
| 92020 | 3.5% | 2,434 | 2,417 | $39K | |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 3.3% | 1,833 | 933 | $38K |
| 92134 | <1% | 346 | 340 | $9K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 124 | 117 | $4K |
| V2784 | Lens, polycarbonate or equal, any index, per lens | <1% | 9,487 | 4,658 | $4K |
5 more codes
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.