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NPI 1922082957 · Owensboro, KY · Podiatrist
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Sheldon Simon is a podiatrist provider located in Owensboro, Kentucky. This profile covers 14 Medicare and 12 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 | Sheldon Simon |
| Address | 1915 W Parrish Ave |
| City | Owensboro |
| State | KY |
| ZIP | 42301 |
| Taxonomy | Podiatrist |
| NPI Enumerated | December 2, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $113.5K |
| Medicare | $37.4K |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
14 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | 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… | 340 | $50 | $16.8K |
| 11721 | The provider surgically debrides (debulks or removes) 6 or more abnormal, diseased, or infected nails. | 90 | $30 | $2.9K |
| 99204 | The 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… | 40 | $80 | $2.7K |
| 11056 | The provider removes 2 to 4 benign hyperkeratotic lesions by using surgical instruments like a scalpel or curette. | 60 | $40 | $2.6K |
| 97022 | The whirlpool method of treatment is a form of hydrotherapy that uses circulating water and air with varied temperature and pressure settings for the treatment of certain disorders. The whirlpool is… | 230 | $10 | $2.5K |
| 99203 | The provider sees a new 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 provider… | 30 | $80 | $2.2K |
| 29581 | The provider applies a layered bandage to the lower leg, ankle, and foot, to treat venous stasis ulcers and venous insufficiency, the failure of the blood veins immediately below the skin. A… | 30 | $50 | $1.4K |
| 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… | 20 | $80 | $1.3K |
| 11750 | The provider removes part or all of a fingernail or toenail, including the nail plate and matrix and including the lunula if the excision is complete. | 10 | $100 | $1.2K |
| 11720 | The provider surgically debrides (debulks or removes) 1 to 5 abnormal, diseased, or infected nails. | 50 | $20 | $960 |
Showing 1–10 of 14
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 14 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
14 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 99214 | 6,743 | 7,230 | 110 | $70 | $14.1K |
| 11721 | 118 | 160 | 260 | $30 | $13K |
| 29581 | 13 | 20 | 70 | $70 | $9.6K |
| 11056 | 47 | 80 | 90 | $50 | $8.4K |
| 99213 | 735 | 7,250 | 80 | $50 | $7.7K |
| 99204 | 1,466 | 3,200 | 30 | $100 | $4.8K |
| 11720 | 57 | 90 | 80 | $20 | $4.6K |
| 99203 | 1,174 | 2,380 | 30 | $70 | $2.9K |
| 11750 | 63 | 60 | 20 | $100 | $2.6K |
| 20550 | 67 | 130 | 30 | $40 | $1.6K |
Showing 1–10 of 14
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.
12 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | 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… | 3,960 | $20 | $71.2K |
| 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… | 660 | $20 | $15.1K |
| 99204 | The 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… | 90 | $70 | $6.7K |
| 99203 | The provider sees a new 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 provider… | 130 | $50 | $6.4K |
| 20550 | Aponeurosis is an abnormal sheet like extension of the tendon. Injection of a tendon or ligament is the medical therapeutic procedure to reduce the aponeurosis formation. | 210 | $30 | $5.5K |
| 97022 | The whirlpool method of treatment is a form of hydrotherapy that uses circulating water and air with varied temperature and pressure settings for the treatment of certain disorders. The whirlpool is… | 1,180 | $1 | $3.5K |
| 29540 | The provider applies elastic adhesive tape to the ankle or foot to hold the joint or muscles in a fixed position and limit excessive or abnormal movements. Strapping treats muscle strains,… | 310 | $10 | $3.1K |
| A6021 | Collagen dressing, sterile, size 16 sq. in. or less, each | 80 | $10 | $980 |
| 29581 | The provider applies a layered bandage to the lower leg, ankle, and foot, to treat venous stasis ulcers and venous insufficiency, the failure of the blood veins immediately below the skin. A… | 10 | $40 | $560 |
| 73630 | In this diagnostic procedure, the provider takes a minimum of three views of the foot to assess injury, fracture, arthritis, tumor, or congenital abnormality. | 20 | $10 | $190 |
Showing 1–10 of 12
How this provider's Medicaid billing volume and revenue compare to other Kentucky providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Kentucky median
12 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… | 968 | 3,340 | 1,020 | $30 | $296K |
| 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… | 1,184 | 2,460 | 580 | $40 | $245K |
| 73630 | In this diagnostic procedure, the provider takes a minimum of three views of the foot to assess injury, fracture, arthritis, tumor, or congenital abnormality. | 235 | 250 | 1,080 | $40 | $82.9K |
| 29581 | The provider applies a layered bandage to the lower leg, ankle, and foot, to treat venous stasis ulcers and venous insufficiency, the failure of the blood veins immediately below the skin. A… | 8 | 10 | 580 | $40 | $69.3K |
| 99204 | The 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… | 567 | 1,020 | 120 | $70 | $62K |
| 99203 | The provider sees a new 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 provider… | 688 | 1,400 | 130 | $50 | $45.8K |
| A6021 | Collagen dressing, sterile, size 16 sq. in. or less, each | 5 | 10 | 180 | $100 | $41.6K |
| 97035 | Physical therapists use different treatment modalities that can help strengthen, relax, and heal muscles from their strained conditions. | 108 | 120 | 650 | $10 | $22.9K |
| 20550 | Aponeurosis is an abnormal sheet like extension of the tendon. Injection of a tendon or ligament is the medical therapeutic procedure to reduce the aponeurosis formation. | 14 | 40 | 100 | $50 | $16.3K |
| 97022 | The whirlpool method of treatment is a form of hydrotherapy that uses circulating water and air with varied temperature and pressure settings for the treatment of certain disorders. The whirlpool is… | 2 | 10 | 380 | $10 | $11.5K |
Showing 1–10 of 12
Other providers in the same ZIP code as Sheldon Simon, ranked by combined Medicare and Medicaid revenue.
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