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    v1.0.28
    OpenPayerNPI Medicare & MedicaidKenneth Toler
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    Kenneth Toler — Billing Profile & Reimbursement Data

    NPI 1841295573 · Jackson, MS · Ophthalmology Physician

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    Kenneth Toler is a ophthalmology physician provider located in Jackson, Mississippi. This profile covers 12 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
    OrganizationKenneth Toler
    Address1200 N State St
    CityJackson
    StateMS
    ZIP39202
    TaxonomyOphthalmology Physician
    NPI EnumeratedJune 17, 2005

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

    Payer SourceTotal Paid
    Medicare$293.5K
    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.

    12 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…480$320$150.1K
    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…990$70$69.1K
    92004The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.240$90$21.6K
    66821The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.50$240$10.9K
    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…30$430$10.7K
    76519The provider uses A scan ultrasound echography to measure the axial length of the eye and determine the intraocular lens, or IOL calculation prior to cataract surgery.480$20$10K
    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…160$40$5.8K
    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…180$30$5.3K
    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…100$50$5.2K
    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…160$20$3.7K

    Showing 1–10 of 12

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    12 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    669843224070$470$90.5K
    9201429350170$70$23K
    66982275030$590$21.4K
    668217716050$200$17.6K
    920129922090$50$9.9K
    921363670200$30$7.4K
    920041633050$90$6.3K
    7651942060$30$5.8K
    920834427050$40$3.4K
    9921239396030$30$2.4K

    Showing 1–10 of 12

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Taylor SmithMSOphthalmology Physician$358.9K$0
    Alexander WhittingtonMSOphthalmology Physician$279.1K$0
    Mark KoskoMSOphthalmology Physician$276.3K$0
    John McveyMSOphthalmology Physician$164.6K$48.9K
    Robert MalletteMSOphthalmology Physician$184.6K$0
    Curtis WhittingtonMSOphthalmology Physician$181K$0
    Philip SmithMSOphthalmology Physician$180.4K$0
    Charles McguffeyMSCornea and External Diseases Specialist Physician$100.9K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Mississippi Behavioral Health Services, LLCMSCommunity/Behavioral Health Agency$0$72.8M
    Mississippi Baptist Medical Center, Inc.MSGeneral Acute Care Hospital$0$42M
    Mississippi Children's Home Society - MypacMSMental Illness Community Based Residential Treatment Facility$0$26.5M
    Medical Foundation Of Central Mississippi, Inc.MSInternal Medicine Physician$0$7.5M
    James BrownMSRetina Specialist (Ophthalmology) Physician$5.4M$8.9K
    Tammy YoungMSMedical Oncology Physician$5.1M$0
    Michael BorneMSRetina Specialist (Ophthalmology) Physician$4.5M$1.8K
    Mississippi Physicians, LLPMSEmergency Medicine Physician$0$4.2M
    Justin BakerMSHematology & Oncology Physician$4.1M$0
    Mae Physicians Surgery Center, LLCMSAmbulatory Surgical Clinic/Center$3.4M$114.8K

    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. Mississippi Distribution
    Kenneth Toler — 1 of 12 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Mississippi