Loading...
NPI 1225036197 · St. Henry, OH · Optometrist
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Michael Fishbaugh is a optometrist provider located in St. Henry, Ohio. This profile covers 21 Medicare and 16 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 | Michael Fishbaugh |
| Address | 570 Kremer Hoying Rd. |
| City | St. Henry |
| State | OH |
| ZIP | 45883 |
| Taxonomy | Optometrist |
| NPI Enumerated | July 13, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $1.2M |
| Medicare | $87.7K |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
21 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99214 | The 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… | 250 | $80 | $20.1K |
| 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… | 190 | $60 | $11K |
| 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… | 140 | $80 | $10.9K |
| 92083 | The 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… | 240 | $40 | $9.6K |
| 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,… | 220 | $20 | $5.2K |
| 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 | $90 | $4.9K |
| 92273 | The provider performs an electrophysiologic test of retinal function, which may be referred to as conventional, full–field or Ganzfeld (ffERG) or flash/focal (fERG) electroretinography to assess… | 50 | $90 | $4.5K |
| 92284 | The provider performs a diagnostic test to evaluate how the patient's eyes adjust to changes in light and darkness. This test measures the function of retinal photoreceptors and may include… | 130 | $30 | $4.1K |
| 92283 | The provider uses an optical instrument, such as a Nagel anomaloscope, that uses long wavelengths of yellow–green light, which a patient adjusts, to match a predetermined ratio of red to green light;… | 110 | $30 | $3.6K |
| 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. | 100 | $30 | $2.4K |
Showing 1–10 of 21
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 21 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
21 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 92014 | 538 | 1,390 | 100 | $70 | $12.9K |
| 92273 | 25 | 40 | 90 | $90 | $12.8K |
| 99214 | 4,125 | 20,010 | 100 | $70 | $11.7K |
| 99213 | 3,906 | 20,000 | 70 | $50 | $6.6K |
| 92134 | 325 | 1,010 | 50 | $30 | $6.3K |
| 83516 | 27 | 40 | 110 | $10 | $4.2K |
| 83861 | 35 | 60 | 90 | $20 | $4K |
| 92004 | 196 | 920 | 30 | $90 | $3.9K |
| 92083 | 71 | 950 | 50 | $40 | $3.3K |
| 0509T | 7 | 10 | 50 | $50 | $2.6K |
Showing 1–10 of 21
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.
16 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| V2784 | Lens, polycarbonate or equal, any index, per lens | 10,100 | $30 | $252.6K |
| 92340 | Code 92340 describes the fitting of eyeglasses, except for aphakia (absence of the crystalline lens as after cataract surgery); monofocal | 9,000 | $30 | $252K |
| V2020 | Frames, purchases | 10,710 | $20 | $224.8K |
| 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. | 6,800 | $20 | $142.8K |
| 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… | 2,690 | $50 | $120.9K |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 6,040 | $20 | $108.8K |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 1,930 | $20 | $28.9K |
| 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. | 370 | $50 | $16.8K |
| 92341 | Code 92341 describes the fitting of eyeglasses of bifocal type, i.e., the lens has two separate areas of focus such as an area which gives best near vision and another area giving best far vision. | 550 | $30 | $15.3K |
| V2203 | Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 260 | $20 | $5.2K |
Showing 1–10 of 16
How this provider's Medicaid billing volume and revenue compare to other Ohio providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Ohio median
16 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99214 | The 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… | 4,164 | 4,510 | 500 | $60 | $377.8K |
| 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… | 4,234 | 5,080 | 560 | $40 | $323.9K |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 11 | 420 | 360 | $10 | $102.3K |
| V2020 | Frames, purchases | 21 | 920 | 580 | $10 | $92K |
| V2203 | Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 63 | 180 | 140 | $10 | $77.3K |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 12 | 720 | 370 | $10 | $57.2K |
| V2303 | Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens | 11 | 10 | 210 | $20 | $47.9K |
| V2104 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens | 54 | 110 | 70 | $10 | $47K |
| 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… | 108 | 1,070 | 390 | $40 | $46.9K |
| V2107 | Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens | 50 | 80 | 60 | $10 | $41K |
Showing 1–10 of 16
Other providers in the same ZIP code as Michael Fishbaugh, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Scott Mcclure | OH | Chiropractor | $19.1K | $0 |
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.