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NPI 1447271473 · Kingston, PA · Optometrist
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Mark Grohol is a optometrist provider located in Kingston, Pennsylvania. This profile covers 15 Medicare and 24 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 | Mark Grohol |
| Address | 703 Rutter Ave |
| City | Kingston |
| State | PA |
| ZIP | 18704 |
| Taxonomy | Optometrist |
| NPI Enumerated | July 23, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $697.4K |
| Medicare | $221.5K |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
15 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… | 1,110 | $70 | $82.1K |
| 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… | 400 | $90 | $34.7K |
| 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… | 400 | $40 | $16.6K |
| 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… | 280 | $60 | $16.1K |
| 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. | 530 | $30 | $13.9K |
| 92020 | The provider examines the angle of the anterior chamber of the eye (the angle where the iris and cornea meet) using a special lens (goniolens) and slit–lamp or operating microscope to diagnose and… | 710 | $20 | $13.6K |
| 68761 | The provider places a plug to close off the lacrimal punctum and block excessive drainage of tears. He performs this procedure to treat dry eye syndrome. | 90 | $150 | $12.7K |
| 92133 | The 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… | 400 | $20 | $9.3K |
| 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,… | 320 | $30 | $8.3K |
| 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. | 80 | $80 | $6.7K |
Showing 1–10 of 15
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
15 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 92014 | 46 | 1,570 | 130 | $80 | $21K |
| 99214 | 2,674 | 23,230 | 100 | $80 | $14.5K |
| 68761 | 42 | 140 | 40 | $140 | $11.9K |
| 92134 | 145 | 1,320 | 60 | $30 | $8.4K |
| 99213 | 2,642 | 22,370 | 70 | $60 | $7.7K |
| 83861 | 45 | 110 | 120 | $20 | $5.8K |
| 92004 | 166 | 1,060 | 30 | $100 | $5K |
| 92083 | 51 | 1,310 | 50 | $40 | $4.1K |
| 92250 | 102 | 1,270 | 60 | $30 | $2.9K |
| 92133 | 53 | 1,270 | 50 | $20 | $2.4K |
Showing 1–10 of 15
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.
24 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| V2784 | Lens, polycarbonate or equal, any index, per lens | 6,720 | $30 | $201.5K |
| 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… | 3,330 | $50 | $149.7K |
| V2783 | Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens | 2,080 | $50 | $93.4K |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 3,810 | $20 | $68.6K |
| 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. | 790 | $60 | $45.5K |
| V2020 | Frames, purchases | 3,820 | $10 | $26.7K |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 1,720 | $20 | $25.9K |
| 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. | 3,600 | $10 | $18K |
| V2203 | Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 800 | $20 | $16.7K |
| 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… | 150 | $50 | $7.5K |
Showing 1–10 of 24
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
24 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… | 5,223 | 8,160 | 210 | $60 | $68.4K |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 159 | 620 | 350 | $30 | $64.6K |
| 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… | 5,731 | 8,870 | 240 | $40 | $56.1K |
| V2783 | Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens | 3 | 20 | 350 | $40 | $50.2K |
| V2025 | Deluxe frame | 35 | 150 | 140 | $50 | $47.1K |
| V2020 | Frames, purchases | 102 | 1,020 | 400 | $30 | $45.5K |
| V2101 | Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens | 13 | 10 | 290 | $20 | $41.2K |
| 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… | 58 | 860 | 240 | $40 | $37K |
| 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. | 149 | 650 | 170 | $40 | $28.7K |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 49 | 520 | 400 | $10 | $28.1K |
Showing 1–10 of 24
Other providers in the same ZIP code as Mark Grohol, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Beyond Behavior Consulting | PA | Behavior Analyst | $0 | $10.3M |
| Keystone Behavior Services, LLC | PA | Community/Behavioral Health Agency | $0 | $6.1M |
| Luzerne Intermediate Unit #18 | PA | Community/Behavioral Health Agency | $0 | $5.7M |
| Bruce Saidman | PA | Hematology & Oncology Physician | $3.4M | $1 |
| David Greenwald | PA | Hematology & Oncology Physician | $2.7M | $590 |
| Surgical Specialty Center Of Northeastern Pennsylvania, LLC | PA | Ambulatory Surgical Clinic/Center | $1.5M | $124.1K |
| Radu Pacurariu | PA | Ophthalmology Physician | $1M | $0 |
| Gateway Surgery Center LLC | PA | Ambulatory Surgical Clinic/Center | $756.7K | $11.8K |
| Dhirendra Kumar | PA | Family Medicine Physician | $638.2K | $0 |
| John Dawsey | PA | Diagnostic Radiology Physician | $461.9K | $0 |
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