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NPI 1376514018 · West Chester, PA · Optometrist
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Maria Higgins is a optometrist provider located in West Chester, Pennsylvania. This profile covers 5 Medicare and 2 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 | Maria Higgins |
| Address | 422 College Ave |
| City | West Chester |
| State | PA |
| ZIP | 19382 |
| Taxonomy | Optometrist |
| NPI Enumerated | January 31, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $308.2K |
| Medicaid | $290 |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 2,480 | $70 | $178.2K |
| 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. | 450 | $120 | $54.5K |
| 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… | 450 | $100 | $45.4K |
| 92002 | The provider performs an intermediate level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program. | 440 | $70 | $30.6K |
| 92202 | The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece… | 20 | $10 | $280 |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.
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.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 40 | $10 | $300 |
| 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. | 30 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Pennsylvania providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Pennsylvania median
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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. | 541 | 650 | 170 | $40 | $28.7K |
| 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… | 252 | 350 | 110 | $30 | $14.4K |
Other providers in the same ZIP code as Maria Higgins, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Gaudenzia Inc | PA | Substance Use Disorder Rehabilitation Clinic/Center | $0 | $18.4M |
| Bayada Home Health Care, Inc. | PA | Home Health Agency | $0 | $15.9M |
| James Benjamin | PA | Ophthalmology Physician | $2.3M | $0 |
| Shabih Khan | PA | Internal Medicine Physician | $372.1K | $2.4K |
| Ignatius Hneleski | PA | Ophthalmology Physician | $291.2K | $0 |
| Raymond Jones | PA | Ophthalmology Physician | $245.7K | $0 |
| Michelle Lopez | PA | Clinical Psychologist | $183K | $0 |
| Thrift Drug Inc | PA | Community/Retail Pharmacy | $134.1K | $0 |
| Rosamund Lehmann | PA | Emergency Medicine Physician | $132K | $0 |
| Laura Hammond | PA | Speech-Language Pathologist | $93.5K | $0 |
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