Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerNPI Medicare & MedicaidGary Gillham
    Ask Trek AI about this page

    Gary Gillham — Billing Profile & Reimbursement Data

    NPI 1245386333 · Springfield, MO · Ophthalmology Physician

    Customize your policy alerts

    Sign up for Gary Gillham — Billing Profile & Reimbursement Data policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Gary Gillham is a ophthalmology physician provider located in Springfield, Missouri. This profile covers 13 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.

    Table of contents

    Progress1 / 8

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationGary Gillham
    Address1229 E Seminole St
    CitySpringfield
    StateMO
    ZIP65804
    TaxonomyOphthalmology Physician
    NPI EnumeratedJanuary 25, 2007

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

    Payer SourceTotal Paid
    Medicare$112.2K
    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.

    13 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    66984The 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…180$320$58K
    92004The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.130$90$12.3K
    66821The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.50$250$12.3K
    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$80$6.8K
    66982The provider inserts an intraocular lens prosthesis after extracapsular cataract extraction using complex techniques and devices. He may perform this by means of an iris expansion device, providing…10$460$6.5K
    92136The provider uses a noninvasive method to measure the patient’s eye or eyes to get information that the provider then uses to calculate the appropriate power for an intraocular lens (IOL). Selecting…360$20$6.4K
    92012For 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…50$60$2.9K
    67840In this procedure, the provider excises a diseased or damaged area from the eyelid, excluding a chalazion, an inflamed oil gland. If necessary, he closes the wound with sutures.20$160$2.9K
    92002The provider performs an intermediate level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program.30$60$1.5K
    67800In this procedure, the provider removes a chalazion, a small nodule that results from a blockage of an oil gland and ongoing inflammation.10$100$1K

    Showing 1–10 of 13

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    13 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    6698410842050$390$74K
    66982788020$610$22.5K
    6682111622050$210$21.2K
    92014418730120$80$18K
    9201220033070$60$8.8K
    9213449457060$30$6.8K
    9213626180140$30$5.1K
    67840112020$180$5K
    920043853030$90$4.6K
    9208344053050$40$3.5K

    Showing 1–10 of 13

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Gary Gillham, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Mercy Hospital SpringfieldMOGeneral Acute Care Hospital$0$64.5M
    Mercy Clinic Springfield CommunitiesMOFamily Medicine Physician$0$51.5M
    Mercy Hospital JoplinMOGeneral Acute Care Hospital$0$46.7M
    Mercy Hospital SpringfieldMOLand Ambulance$0$46.7M
    Mercy Clinic Joplin LLCMOFamily Medicine Physician$0$20.4M
    Mercy Hospital CarthageMOCritical Access Hospital$0$18.8M
    Mercy Clinic Springfield CommunitiesMOFamily Medicine Physician$0$15.1M
    Mercy Hospital AuroraMOCritical Access Hospital$0$9.9M
    Mercy Hospital SpringfieldMOGeneral Acute Care Hospital$0$6.6M
    Mercy Hospital SpringfieldMOAir Ambulance$0$6.5M

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Burrell, Inc.MOCommunity/Behavioral Health Agency$0$758.9M
    Phoenix Home Care, LLCMONursing Care Agency$0$199.5M
    Phoenix Home Care, LLCMOIn Home Supportive Care Agency$0$149M
    Integrity Home Care, LLCMOHome Health Agency$0$115.7M
    Preferred Family Healthcare, Inc.MOIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility$0$23M
    Premier Home Health Care, Inc.MOHome Health Agency$0$12.1M
    Burrell, Inc.MOCommunity/Behavioral Health Agency$0$9.1M
    2gethertech, LLCMOIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility$0$7.5M
    Easter Seals MidwestMOIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility$0$5.7M
    Elite Pain Management, LLCMOPain Medicine (Physical Medicine & Rehabilitation) Physician$0$3.5M

    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. Missouri Distribution
    Gary Gillham — 0 of 13 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Missouri