Loading...
NPI 1700017902 · Dover, DE · Ophthalmology Physician
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Timothy Doyle is a ophthalmology physician provider located in Dover, Delaware. This profile covers 19 Medicare and 6 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 | Timothy Doyle |
| Address | 833 S Governors Ave |
| City | Dover |
| State | DE |
| ZIP | 19904 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | August 5, 2009 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $983K |
| Medicaid | $38.7K |
Practice revenue mix shows a surgical plus clinic orientation: the provider’s top three Medicare codes (66984, J0178, 99213) account for 58.3% of Medicare revenue, with 66984 (cataract extraction with IOL) at $233.5K (23.7% of Medicare revenue), J0178 (aflibercept injection) at $176.3K (17.9%), and 99213 (established office E/M) at $164.1K (16.7%). This combination indicates a core business that blends cataract surgery, intravitreal therapy, and very high-volume outpatient visits rather than a pure surgical or pure retina specialty practice.
Medicare billing is concentrated: the precomputed top-3 Medicare codes account for 58.3% of total Medicare revenue ($983K total Medicare revenue). The single largest line is cataract surgery (66984, $233.5K) but substantial revenue also comes from aflibercept injections (J0178, $176.3K) and routine E/M (99213, $164.1K), so a few services drive the majority of Medicare receipts.
Operational capacity is supported by in‑office diagnostic imaging and testing: high-volume imaging and testing codes such as 92134 (1.9K claims, $55.7K, ranks #1119 of 26868 nationally, 96th percentile), 92250 (766 claims, $18.4K, ranks #497 of 25087, 98th percentile), and 92083 (834 claims, $35.9K, ranks #157 of 25484, 99th percentile) are notably above typical national volumes. These patterns are consistent with an ophthalmology practice that performs both retina monitoring/diagnostics and pre/post‑op assessments in-house.
The provider is an extreme outlier on general ophthalmology visit volume: 99213 has 2.8K claims and $164.1K in Medicare revenue and is labeled an "extreme outlier, far above typical national volume" (ranks #267 of 457151, 100th percentile), with 99214 also very high (1.5K claims, $128.6K, ranks #3621 of 479517, 99th percentile). This suggests a very high outpatient throughput and front‑line clinic workload relative to national peers, driving substantial E/M revenue.
Cataract surgery footprint is solid but not dominant nationally: 66984 shows 552 claims and $233.5K in Medicare revenue and ranks #2741 of 15965 nationally (83th percentile, described as typical, unremarkable volume). A companion complex cataract code 66982 appears as well (97 claims, $56.8K, ranks #380 of 4580, 92th percentile), indicating the practice performs both routine and some complex cataract cases but is not an outlier surgical center.
Anti‑VEGF/injection activity is a meaningful revenue stream but modest versus national retina leaders: J0178 (aflibercept) produced $176.3K from 254 claims yet ranks #2426 of 3204 nationally (24th percentile, typical, unremarkable volume), and intravitreal injection code 67028 also ranks in the 24th percentile. In other words, injections materially contribute to revenue but the provider is not a high-volume national injector.
Medicaid activity is much smaller and concentrated in routine eye exams: total Medicaid revenue is $38.7K and the top three Medicaid codes (92012, 92014, 99213) account for 92.2% of that Medicaid revenue, with 92012 at $14.1K (36.4%), 92014 at $11.8K (30.5%), and 99213 at $9.8K (25.3%). State-level ranks for those codes are modest (for example, 92012 ranks #12 of 24 in-state, 52th percentile; 99213 ranks #407 of 543 in-state, 25th percentile), indicating the provider is a modest Medicaid participant focused on intermediate/comprehensive exams and E/Ms rather than procedural Medicaid work.
Payer mix and tenure point to a Medicare-dominant, established practice: Medicare revenue ($983K) dwarfs Medicaid revenue ($38.7K), making the provider effectively Medicare-focused in scale. The NPI was enumerated on 2009-08-05 (~17 years ago), signifying a long-tenured clinician likely operating an established outpatient ophthalmology practice serving a predominantly Medicare population.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
19 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 66984 | The 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… | 550 | $420 | $233.5K |
| J0178 | Injection, aflibercept, 1 mg | 250 | $690 | $176.3K |
| 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… | 2,780 | $60 | $164.1K |
| 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… | 1,500 | $90 | $128.6K |
| 66982 | The 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… | 100 | $590 | $56.8K |
| 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. | 1,920 | $30 | $55.7K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 150 | $250 | $38K |
| 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… | 830 | $40 | $35.9K |
| 92136 | The 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… | 660 | $30 | $19K |
| 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,… | 770 | $20 | $18.4K |
Showing 1–10 of 19
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
19 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 5 | 10 | 510 | $680 | $495.6K |
| 66984 | 12 | 50 | 70 | $590 | $163.6K |
| 67028 | 7 | 10 | 970 | $90 | $85.6K |
| 66982 | 9 | 20 | 60 | $700 | $60K |
| 66821 | 15 | 30 | 140 | $230 | $37.1K |
| 99214 | 46 | 1,830 | 150 | $80 | $25.5K |
| 99213 | 3 | 1,810 | 120 | $60 | $13.6K |
| 92136 | 3 | 20 | 160 | $30 | $8.3K |
| 92134 | 3 | 100 | 80 | $30 | $7.5K |
| 99204 | 191 | 950 | 30 | $110 | $6.5K |
Showing 1–10 of 19
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.
6 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… | 270 | $50 | $14.1K |
| 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… | 240 | $50 | $11.8K |
| 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… | 150 | $70 | $9.8K |
| V2020 | Frames, purchases | 60 | $30 | $1.5K |
| 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. | 40 | $30 | $1.2K |
| 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. | 50 | $10 | $280 |
How this provider's Medicaid billing volume and revenue compare to other Delaware providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Delaware median
6 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 407 | 540 | 1,100 | $40 | $185.3K |
| 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… | 25 | 40 | 330 | $50 | $172.4K |
| 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. | 13 | 20 | 1,530 | $20 | $170.6K |
| V2020 | Frames, purchases | 56 | 60 | 530 | $30 | $46.3K |
| 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… | 12 | 20 | 230 | $30 | $36.8K |
| 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. | 29 | 40 | 460 | $10 | $22.4K |
Other providers in the same ZIP code as Timothy Doyle, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Bayada Home Health Care, Inc. | DE | Home Health Agency | $0 | $37.9M |
| At Home Infucare, LLC | DE | Home Health Agency | $0 | $28.5M |
| Amazing Home Care Agency | DE | Home Health Agency | $0 | $18.7M |
| Dedicated To Women Ob-gyn, P.A. | DE | Obstetrics & Gynecology Physician | $0 | $11.1M |
| Help At Home Of Delaware, LLC | DE | In Home Supportive Care Agency | $0 | $10.7M |
| A Center For Mental Wellness, Inc. | DE | Mental Health Counselor | $0 | $9.9M |
| State Of Delaware | DE | Case Management Agency | $0 | $9.2M |
| West Dover Dental, LLC | DE | Dentist | $0 | $9M |
| Americare Home Solutions | DE | In Home Supportive Care Agency | $0 | $8.4M |
| Vicdania Health Services LLC | DE | Home Health Agency | $0 | $7.4M |
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.