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Helen K Ma, OD

Optometry · Palo Alto

NPI 1073689154

Medicare standing
Clear
Enrolled, allowed to bill and order, not excluded
Plans that list them
Not verified
Not the same as out of network.
Offices
2

Offices

2 locations · Sutter Bay Medical Foundation · 3,783 clinicians in this group

Looking this up.

Plan participation

Not verified

We could not verify current plan participation for this doctor. This does not mean they are out of network. Call Dr. Ma’s office to ask if they take your plan before you enroll.

Original Medicare doctor bills

$29,050

Medicare paid this office $29,050 for 255 people.

This is what Medicare paid the clinician — not Medicare Advantage, and not the pharmacy.

Largest Original Medicare bills
Established patient complete exam of visual system111$11,993$108
New patient complete exam of visual system55$6,062$110
Short return visit (20+ min)33$2,776$77
New patient visit (30+ min)23$2,340$102
Imaging of retina38$1,448$38
See all 8 services
Every Original Medicare service billed
Established patient complete exam of visual system111$11,993$108
New patient complete exam of visual system55$6,062$110
Short return visit (20+ min)33$2,776$77
New patient visit (30+ min)23$2,340$102
Imaging of retina38$1,448$38
Short return visit21$1,011$44
Imaging of optic nerve25$843$32
Photography of the retina15$339$23

Who their Medicare patients are

255 Original Medicare patients in 2024. Average age 77 · Women 58% · Also on Medicaid 10% · Health risk score 0.87. At or below the middle of the specialty; the typical optometry clinician is at 0.97.

Conditions among them: High blood pressure 60% · Coronary heart disease 22% · Diabetes 18% · Chronic kidney disease 17% · Cancer 16% · Atrial fibrillation 16% · Depression 14% · COPD 8% · Heart failure 7% · Dementia 4%.

The office billed $130,797, Medicare allowed $44,104 and paid $29,050; for 356 services of 14 kinds.

Original Medicare patients only. A risk score of 1.0 is the average Medicare patient; higher means sicker. Any count under 11 is hidden.

Year by year

Original Medicare by year
2024255356770.87$130,797$29,050
2023221296760.73$104,396$23,406
2022191259760.79$85,630$21,485
2021207288760.84$94,649$23,634
2020141192760.79$61,900$14,715
2019194247760.94$83,676$20,941
2018171224760.81$74,006$18,775
2017138161740.81$56,797$14,475
2016144172740.86$56,034$13,952
2015108125740.96$41,438$10,790
2014104116750.79$38,528$8,952
20137792730.86$30,791$7,303

Original Medicare only. A service billed for fewer than 11 people in a year is hidden, so the lines can add up to less than the year's total.

See the services billed each year

2023: 7 services

Original Medicare services billed in 2023
Established patient complete exam of visual system98$9,775$100
New patient complete exam of visual system38$3,789$100
New patient visit (30+ min)23$2,316$101
Short return visit (20+ min)25$2,125$85
Imaging of retina37$1,207$33
Short return visit16$735$46
Imaging of optic nerve23$622$27

2022: 7 services

Original Medicare services billed in 2022
Established patient complete exam of visual system93$9,945$107
New patient complete exam of visual system27$3,126$116
Short return visit (20+ min)35$3,094$84
New patient visit (30+ min)13$1,194$92
Imaging of retina24$959$38
Short return visit17$785$46
Imaging of optic nerve21$751$36

2021: 6 services

Original Medicare services billed in 2021
Established patient complete exam of visual system100$10,986$110
Short return visit (20+ min)33$3,030$78
New patient complete exam of visual system29$2,908$100
New patient visit (30+ min)15$1,543$103
Imaging of retina28$1,070$38
Imaging of optic nerve23$796$35

2020: 6 services

Original Medicare services billed in 2020
Established patient complete exam of visual system67$7,435$111
New patient complete exam of visual system23$2,377$103
Short return visit (20+ min)18$1,356$71
Imaging of retina17$731$41
Short return visit13$494$38
Imaging of optic nerve14$456$33

2019: 7 services

Original Medicare services billed in 2019
Established patient complete exam of visual system90$9,710$108
New patient complete exam of visual system37$4,326$117
Short return visit (20+ min)22$1,511$60
New patient visit (30+ min)11$995$90
Imaging of retina20$823$41
Imaging of optic nerve16$593$37
Short return visit13$536$41

2018: 6 services

Original Medicare services billed in 2018
Established patient complete exam of visual system76$8,011$105
New patient complete exam of visual system35$4,156$119
Short return visit (20+ min)27$1,844$61
New patient visit (30+ min)13$1,076$83
Imaging of retina15$574$38
Imaging of optic nerve16$559$35

2017: 5 services

Original Medicare services billed in 2017
Established patient complete exam of visual system62$6,508$105
New patient complete exam of visual system33$3,593$109
New patient visit (30+ min)13$1,208$93
Short return visit (20+ min)18$1,177$62
Imaging of optic nerve13$475$37

2016: 6 services

Original Medicare services billed in 2016
Established patient complete exam of visual system50$4,556$91
New patient complete exam of visual system32$4,029$126
Short return visit (20+ min)30$1,938$59
New patient visit (30+ min)12$1,054$88
Imaging of optic nerve11$470$43
Short return visit11$386$35

2015: 4 services

Original Medicare services billed in 2015
Established patient complete exam of visual system51$5,387$106
Short return visit (20+ min)24$2,024$70
New patient complete exam of visual system17$1,960$115
New patient visit (15+ min)13$818$63

2014: 3 services

Original Medicare services billed in 2014
Established patient complete exam of visual system37$3,324$90
New patient complete exam of visual system22$2,593$118
Short return visit (20+ min)34$1,903$54

2013: 3 services

Original Medicare services billed in 2013
Established patient complete exam of visual system37$3,666$99
Short return visit (20+ min)23$1,572$63
New patient complete exam of visual system12$1,130$94

Drugs they prescribed that Part D paid

$1,015

Pharmacies billed $1,015 in 2024.

This is pharmacy cost, not the office bill, and not what patients paid.

Opioids were 0% of their Part D prescriptions (0 of 46) in 2024. Too few prescriptions to compare fairly with other clinicians.

35 generic and 11 brand-name prescriptions · $1,015 in drug cost.

Part D prescriptions only. The opioid rate is opioid prescriptions as a share of all this clinician's Part D prescriptions; surgeons and pain specialists run higher than others, so it is shown against the same specialty.

Largest Part D drug costs
Erythromycin17$193$9

Year by year

Part D prescribing by year
202446360% (0)24%$1,015
202346390% (0)24%$3,273
202234280% (0)None$656
202121180% (0)None$2,166
202023170% (0)48%$4,732
201919130% (0)None$4,563
201835150% (0)60%$2,357
201715None0% (0)73%$1,865
201621160% (0)None$1,289
201536260% (0)67%$3,963
201437150% (0)81%$4,895
201339190% (0)56%$5,770

Part D prescriptions only. A drug prescribed to fewer than 11 people in a year is hidden.

See the drugs prescribed each year

2023: 1 drug

Part D drugs prescribed in 2023
Erythromycin28$292$10

2022: 2 drugs

Part D drugs prescribed in 2022
Erythromycin15$157$10
Neomycin-Polymyxin-Dexameth12$116$10

2018: 1 drug

Part D drugs prescribed in 2018
Olopatadine20$1,074$54

2015: 1 drug

Part D drugs prescribed in 2015
Pataday11$1,699$154

2014: 1 drug

Part D drugs prescribed in 2014
Pataday20$2,797$140

2013: 1 drug

Part D drugs prescribed in 2013
Pataday12$1,557$130

Professional record

NPI
1073689154
Licence
CA OPT10372
Gender
Female
More record details
Sole proprietor
No
Taxonomy
Federal specialty code 152W00000X (152W00000X)
Mailing address
325 Distel Cir, Los Altos, CA, 94022
NPI first listed
2006-11-28
NPI last updated
2020-03-04
NPI record certified
2020-03-04

This is when the NPI record was last certified, not a medical board exam.