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    v1.0.28
    OpenPayerNPI Medicare & MedicaidMark Sherman
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    Mark Sherman — Billing Profile & Reimbursement Data

    NPI 1326056235 · San Luis Obispo, CA · Ophthalmology Physician

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    Mark Sherman is a ophthalmology physician provider located in San Luis Obispo, California. This profile covers 21 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.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationMark Sherman
    Address628 California Blvd
    CitySan Luis Obispo
    StateCA
    ZIP93401
    TaxonomyOphthalmology Physician
    NPI EnumeratedAugust 4, 2006

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

    Payer SourceTotal Paid
    Medicare$219K
    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.

    21 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    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…1,100$90$100.7K
    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…390$90$34.6K
    65778The provider places amniotic membrane on the ocular surface, similar to the placement of a contact lens.20$1,220$20.8K
    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…220$60$13.5K
    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…260$40$11.2K
    99490The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…150$50$7.2K
    92133The provider performs computerized diagnostic imaging of the optic nerve in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both…460$10$6K
    92004The 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$5.4K
    66821The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.20$260$4.4K
    99204The provider sees a new 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 provider…30$110$3.2K

    Showing 1–10 of 21

    Medicare: Competitive Analysis & Benchmarks

    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 CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    65778779040$1,190$104.6K
    920146782,890110$100$28.7K
    994906351,060210$50$25.8K
    992141,31837,970120$90$23.2K
    6682182895040$270$18.4K
    992138,31634,66080$70$13.2K
    921349222,15090$30$12.6K
    99439387510130$40$12.3K
    920047971,95050$110$9.7K
    9920411,26319,36040$120$7.2K

    Showing 1–10 of 21

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Seventh-day Adventists Loma Linda University Medical CenterCAGeneral Acute Care Hospital$0$253.4M
    Faculty Physicians And Surgeons Of LlusmCAPediatrics Physician$0$66.4M
    Faculty Physicians And Surgeons Of LlusmCASurgery Physician$0$54.9M
    Stephen CouvillionCARetina Specialist (Ophthalmology) Physician$6.4M$0
    Alessandro CastellarinCARetina Specialist (Ophthalmology) Physician$5.4M$0
    William PaceCANuclear Medicine Physician$4.1M$0
    Dante PieramiciCARetina Specialist (Ophthalmology) Physician$3.7M$0
    Daniel GreenwaldCAMedical Oncology Physician$3.5M$0
    Ma'an NasirCARetina Specialist (Ophthalmology) Physician$3M$0
    Julian DavisCAHematology & Oncology Physician$2.7M$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    County Of San Luis ObispoCACommunity/Behavioral Health Agency$0$66.8M
    Pacific Point Laboratories, Inc.CAClinical Medical Laboratory$8.5M$38.8M
    Community Health Centers Of The Central Coast IncCAFederally Qualified Health Center (FQHC)$0$25.3M
    San Luis Ambulance Service, Inc.CALand Ambulance$4.3M$7.8M
    Brian DicarloCAHematology & Oncology Physician$4.7M$0
    San Luis Obispo Surgery Center A California Limited PartnershipCAAmbulatory Surgical Clinic/Center$2.9M$0
    Daniel AgarwalCAOphthalmology Physician$2.3M$0
    Erin ChamberlainCAHematology & Oncology Physician$1.9M$0
    California Medical Surgery Center LLCCAAmbulatory Surgical Clinic/Center$1.7M$0
    Steven JohnsonCAOphthalmology Physician$1.5M$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. California Distribution
    Mark Sherman — 1 of 21 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — California