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NPI 1083692214 · Oskaloosa, IA · Optometrist
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James Else is a optometrist provider located in Oskaloosa, Iowa. This profile covers 9 Medicare and 8 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | James Else |
| Address | 200 High Ave W |
| City | Oskaloosa |
| State | IA |
| ZIP | 52577 |
| Taxonomy | Optometrist |
| NPI Enumerated | January 6, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $237.7K |
| Medicare | $35.4K |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
9 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 92014 | An 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… | 220 | $70 | $15.3K |
| 92012 | For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any… | 140 | $40 | $6K |
| 92004 | The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits. | 60 | $80 | $4.4K |
| 66984 | The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to… | 50 | $80 | $4.2K |
| 99213 | The 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… | 50 | $50 | $2.8K |
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 30 | $40 | $970 |
| 92002 | The provider performs an intermediate level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program. | 20 | $30 | $820 |
| 92250 | Code 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,… | 20 | $20 | $430 |
| 92134 | The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes. | 20 | $20 | $380 |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
8 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 92004 | The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits. | 1,380 | $90 | $124.4K |
| 92012 | For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any… | 1,210 | $50 | $55.6K |
| 92002 | The provider performs an intermediate level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program. | 490 | $50 | $26.6K |
| 92014 | An 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… | 360 | $60 | $22.1K |
| V2020 | Frames, purchases | 320 | $20 | $7.4K |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 40 | $20 | $710 |
| V2756 | Eye glass case | 230 | $1 | $230 |
| 92015 | The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced. | 2,590 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Iowa providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Iowa median
8 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 92014 | An 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… | 209 | 450 | 290 | $60 | $42.8K |
| 92004 | The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits. | 35 | 350 | 140 | $80 | $39.5K |
| V2020 | Frames, purchases | 234 | 420 | 420 | $20 | $22.3K |
| 92012 | For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any… | 10 | 160 | 160 | $40 | $16.3K |
| 92002 | The provider performs an intermediate level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program. | 10 | 100 | 90 | $50 | $12.2K |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 208 | 270 | 150 | $20 | $9.2K |
| 92015 | The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced. | 35 | 420 | 310 | $10 | $5.8K |
| V2756 | Eye glass case | 132 | 240 | 290 | $1 | $720 |
Other providers in the same ZIP code as James Else, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Mahaska County Hospital | IA | Critical Access Hospital | $0 | $4.9M |
| Mahaska County Hospital | IA | Family Medicine Physician | $0 | $3.3M |
| Homestead Of Oskaloosa Operations LLC | IA | Assisted Living Facility | $0 | $3.1M |
| Oskaloosa Csd | IA | Local Education Agency (LEA) | $0 | $1.9M |
| Robert Pettis | IA | Otolaryngology Physician | $411.5K | $0 |
| Cheryl Ervin | IA | Certified Registered Nurse Anesthetist | $115.5K | $0 |
| David North | IA | Family Medicine Physician | $88.9K | $19.5K |
| Karen Spahr | IA | Internal Medicine Physician | $44.6K | $41.1K |
| Jacquelene Garden | IA | Gerontology Nurse Practitioner | $63.9K | $0 |
| Lisa Nelson | IA | Adult Health Nurse Practitioner | $58.6K | $0 |
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