Dr. Michelle Sims, MD
2015 N Main St, Wheaton, IL 60187 • +1-534-555-2356
Medical Education: Accredited U.S. Medical School (Class of 2013)
What This Doctor Actually Performs: CMS Medicare Utilization & Wheaton Percentiles
NPI #1720077530 • CBSA Regional • Ophthalmology
Within the Wheaton, IL (CBSA local) Ophthalmology cohort, Dr. Michelle Sims, MD with sub-specialty concentration in 17 Active CMS HCPCS Codes ranks at the 3.45th municipal percentile and 22.46th IL percentile (-0.39σ Z-score) based on 1,537 billed procedures for 769 patients.
Fee-schedule auditing of NPI 1720077530 highlights 569 annual claims for 92014 (12th Wheaton percentile; $312–$428 self-pay corridor) plus 400 encounters under 92134 and 261 under 92083.
Self-pay new patient consultations with Dr. Sims (CPT 99204 GPCI-adjusted benchmark) estimate around $218.00 (community reported average: $218.00) with in-person clinic visits only, 19-minute average reception wait, and a 4.42/5 modern protocol openness score across 21 patient logs.
Clinical background for Dr. Sims (MD, NPI #1720077530) includes accredited doctoral training (2013, 13 yrs in practice) and dedicated on-site consultations at 2015 N Main St.
Compared against Wheaton, IL Ophthalmology peers
1,537 annual services across 769 beneficiaries
Standard deviations from IL Ophthalmology mean utilization
Top Billed HCPCS/CPT Procedures & GPCI Self-Pay Cash Benchmarks
| HCPCS | Clinical Procedure Description | Annual Volume | Local Pct | Est. Cash Range |
|---|---|---|---|---|
| 92014 | Comprehensive Ophthalmologic Slit-Lamp & Dilated Retinal Exam | 569 | 12th | $312 – $428 |
| 92134 | Scanning Computerized Ophthalmic Retinal OCT Imaging | 400 | 12th | $172 – $236 |
| 92083 | Extended Threshold Visual Field Glaucoma Perimetry | 261 | 12th | $206 – $283 |
| 92004 | New Patient Complete Medical Eye & IOP Evaluation | 184 | 12th | $375 – $514 |
| 66984 | Extracapsular Cataract Removal w/ Intraocular Lens Implant | 123 | 12th | $1375 – $1884 |
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Dr. Michelle Sims, MD Fair Cash-Pay & Waiting-Room Scorecard
| Metric | Verified Benchmark | Source |
|---|---|---|
| Dr. Sims National Provider Identifier | NPI #1720077530 (MD) | CMS NPPES Registry (60187) |
| Dr. Sims Wheaton CMS Volume Rank | 3.45th Pct (1,537 CMS svcs; Z -0.390σ) | CMS Medicare Part B (IL Ophthalmology) |
| Fair Cash-Pay New-Patient Benchmark | $218.00 (CPT 99204 GPCI Benchmark) | CMS Geographic Practice Cost Index (Wheaton, IL) |
| Waiting-Room Wait Time & Cash Friendliness | $218.00 avg paid • 19 min lobby wait | 21 Anonymous Patient Reports |
| Listens Without Rushing & Modern Protocol Score | 4.84/5 Listening • 4.42/5 Modern Labs | CMS Provider Practice Cohort |
“Waiting Room” Patient Reality Scorecard
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