Koutnik, Edward
Koutnik, Edward was paid $755K by Medicaid between Jan 2018 and Apr 2024, across 24 billing codes. Its largest line is 92014, Ophthalmological services: medical examination and evaluation, comprehensive, established patient — 27% of everything it billed.
33Billing provider infoKOUTNIK, EDWARD
STOUGHTON, WI 53589
STOUGHTON, WI 53589
33aNPI1952785578assigned 07/14/2015
33bProvider typeOptometrist
28Total paid$755K
24GClaims28,193
24DCodes billed24
24AFirst – last monthJan 2018 – Apr 2024
Compared with peers
Next to other Optometrist providers in Wisconsin
Rank by total paid#6 of 412
Median peer was paid$7K
This provider vs. median115×
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 | 2,827 | $72K | |
| 2019 | 4,957 | $124K | |
| 2020 | 3,758 | $97K | |
| 2021 | 5,639 | $155K | |
| 2022 | 5,739 | $159K | |
| 2023 | 4,304 | $120K | |
| 2024incomplete | 969 | $27K |
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 | 27% | 5,452 | 5,174 | $206K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 16% | 2,670 | 2,509 | $120K |
| 92015 | Determination of refractive state | 14% | 6,013 | 5,749 | $105K |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | 11% | 2,877 | 2,686 | $80K |
| 92341 | 5.4% | 1,548 | 1,377 | $41K | |
| 68761 | 5.3% | 626 | 444 | $40K | |
| V2020 | Frames, purchases | 3.1% | 1,801 | 1,676 | $23K |
| 83861 | 3.0% | 1,047 | 700 | $23K | |
| 92083 | 3.0% | 794 | 742 | $23K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 2.5% | 756 | 681 | $19K |
| V2025 | Deluxe frame | 2.0% | 390 | 368 | $15K |
| 83516 | 1.4% | 828 | 615 | $10K |
12 more codes
| 92250 | 1.2% | 275 | $9K | |
| 99214 | Doctor's office visit, returning patient (more involved) | 1.1% | 226 | $9K |
| 92133 | 1.1% | 407 | $8K | |
| V2784 | Lens, polycarbonate or equal, any index, per lens | <1% | 974 | $6K |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | <1% | 315 | $6K |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | <1% | 686 | $6K |
| 92020 | <1% | 127 | $2K | |
| V2203 | Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | <1% | 180 | $2K |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | <1% | 137 | $2K |
| S0621 | Routine ophthalmological examination including refraction; established patient | <1% | 13 | $577.85 |
| 99072 | <1% | 15 | $10.00 | |
| 3072F | 0% | 36 | $0.00 |
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.