Physician

Philip Michael Smith, M.D.

According to 2025 Medicare claims, Philip Smith, M.D. (NPI: 1952351876) practices ophthalmology in the Appleton, WI market, with the plurality of this provider's patient population coming from Outagamie, WI. This provider's primary affiliated billing organization is VALLEY EYE ASSOCIATES (NPI: 1699789032; TIN: 391791932) and primary practice location at 54914-9106. Smith is affiliated with the THEDACARE ACO (ACO ID: A4988), participating under the MSSP model.

Smith's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 190 traditional Medicare patients, billed 771 HCPCS/CPT codes, and received $106,461 in Medicare payments. The top billing code was 66984 (Removal of cataract with insertion of prosthetic lens). Part D data shows 1,015 prescription claims across 385 beneficiaries totaling $53,622 in drug costs, led by Prednisolone Acetate (Prednisolone Acetate). 2018 DME data shows 31 claims. Open Payments data shows 50 records totaling $2,725. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider's Medicare Part B carrier billing has moved up and down with repeated peaks and valleys, starting at $13,981 and ending at $106,461. Concurrently, Part D prescription costs have fallen sharply in recent years, from $98,761 to $53,622. For DME billing, this provider has fewer than 5 years of reported data, so a reliable trend cannot be assigned.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Year	Patients	Clm Lines	Payment
2015	116	188	$13,981
2016	451	1,039	$235,430
2017	1,126	3,655	$638,218
2018	1,079	3,733	$696,464
2019	955	3,193	$550,728
2020	759	2,093	$285,718
2021	259	798	$136,627
2022	849	3,181	$410,321
2023	860	3,773	$694,906
2024	190	771	$106,461

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

Year	Patients	Claims	Drug Cost
2015	216	715	$98,761
2016	190	607	$92,823
2017	789	2,223	$296,539
2018	972	3,597	$422,500
2019	1,047	3,417	$509,816
2020	869	3,535	$619,008
2021	631	1,886	$182,923
2022	491	1,462	$77,924
2023	364	708	$1,113,969
2024	385	1,015	$53,622

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

Year	Patients	Claims	Payment
2015	N/R	N/R	N/R
2016	N/R	N/R	N/R
2017	50	50	$3,823
2018	31	31	$2,243
2019	N/R	N/R	N/R
2020	N/R	N/R	N/R
2021	N/R	N/R	N/R
2022	N/R	N/R	N/R
2023	N/R	N/R	N/R
2024	N/R	N/R	N/R

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

Code	Description	Patients	Clm Lines	Total Payment
66984	Removal of cataract with insertion of prosthetic lens	78	142	$390
66821	Removal of recurring cataract in lens capsule using a laser	26	58	$159
99204	New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	50	50	$120
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	58	58	$98
92136	Measurement of corneal curvature and depth of eye	93	270	$20

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Prednisolone Acetate	Prednisolone Acetate	342	12,193	$14,613
Prolensa	Bromfenac Sodium	21	845	$7,328
Rocklatan	Netarsudil Mesylat/Latanoprost	14	326	$4,734
Ketorolac Tromethamine	Ketorolac Tromethamine	244	6,756	$4,496
Bromfenac Sodium	Bromfenac Sodium	13	474	$2,284

Top 5 DME services in 2024

No connected or detailed DME service-level records for 2024.

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	50	$2,725	Alcon Vision LLC
Research Payments	Reported research-related payment or transfer-of-value amount.	0	$0	N/R
Ownership / Investment Interests	Reported value of ownership or investment interests.	0	$0	N/R

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FAQ

What Medicare data is available for Philip Michael Smith, M.D.?

Tedicare shows public-source Medicare data for Philip Michael Smith, M.D. (NPI 1952351876), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does Philip Michael Smith, M.D. have ACO affiliation data?

Philip Michael Smith, M.D. is shown with ACO affiliation data for THEDACARE ACO (MSSP, ACO ID A4988).

What billing organization is linked to Philip Michael Smith, M.D.?

Philip Michael Smith, M.D. is linked to VALLEY EYE ASSOCIATES (billing NPI 1699789032) in the available physician profile data.

Does Philip Michael Smith, M.D. have Open Payments data?

Philip Michael Smith, M.D. has 50 connected Open Payments records in the available 2024 summary data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.