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    v1.0.28
    OpenPayerNPI Medicare & MedicaidDonald Higgins
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    Donald Higgins — Billing Profile & Reimbursement Data

    NPI 1023147428 · Plainville, CT · Optometrist

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    Donald Higgins is a optometrist provider located in Plainville, Connecticut. This profile covers 15 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

    (source: NPPES NPI Registry)

    Table of contents

    Progress1 / 7

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    Provider details
    FieldValue
    Entity TypeIndividual
    OrganizationDonald Higgins
    Address74 E Main St
    CityPlainville
    StateCT
    ZIP06062
    TaxonomyOptometrist
    NPI EnumeratedMarch 4, 2007

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$63K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    15 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    92014An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…90$100$8.9K
    68761The provider places a plug to close off the lacrimal punctum and block excessive drainage of tears. He performs this procedure to treat dry eye syndrome.100$80$8K
    99214The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…80$90$7.6K
    83861The lab analyst performs microfluidic analysis to test the tear osmolarity of the patient. This is usually done in patients with symptoms of dry eye.330$20$7.2K
    99213The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…80$70$6K
    92100Code 92100 describes multiple measurements of intraocular pressure taken over a given time period on a single day in order to monitor response to treatment or document pressure changes throughout the…70$70$4.6K
    76512The provider uses B–scan ultrasound imaging, with or without a non–qualitative A–scan superimposed, to examine the intraocular and orbital structures.100$50$4.5K
    92083The provider may use one or more methods to determine the extent of a patient's visual field of one or both eyes; he interprets the results and prepares a report. Report this code for an extended…70$50$3.5K
    92250Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…130$30$3.4K
    92285Code 92285 describes photography of abnormalities using any of the methods described for documentation purposes and later comparison.170$20$3.2K

    Showing 1–10 of 15

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    15 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    92014306580100$90$18.6K
    992143,4446,48090$90$14.2K
    6876153040$140$9.9K
    992132,8596,44070$60$8.1K
    9200425841030$110$5.2K
    992042,1902,66030$120$4.6K
    8386163080$20$4.1K
    9208312434040$50$3.8K
    922508843060$30$3.1K
    922023950140$10$3K

    Showing 1–10 of 15

    Nearby Providers

    Other providers in the same ZIP code as Donald Higgins, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Wheeler Clinic IncCTMental Health Clinic/Center (Including Community Mental Health Center)$0$102.6M
    Lance KissCTOrthodontics and Dentofacial Orthopedics Dentistry$0$1.5M
    Clear Horizon Eyecare, LLCCTOptometrist$0$1.2M
    Central Connecticut Endoscopy CenterCTEndoscopy Clinic/Center$341.2K$347.4K
    Robert CarangeloCTOrthopaedic Surgery Physician$252.1K$0
    Bennett MoehlCTClinical Psychologist$106K$0
    Derrick BaileyCTInternal Medicine Physician$93K$0
    Wendy RowlandCTPhysician Assistant$39.6K$0
    Robert WaskowitzCTSports Medicine (Orthopaedic Surgery) Physician$33.7K$0
    Monika KieltykaCTFamily Nurse Practitioner$29.4K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Connecticut Distribution
    Donald Higgins — 1 of 15 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Connecticut