Active NPI 1063494532 Individual Practitioner Male Practitioner

Dr. Terry Vail , OD

Optometrist • Macomb, IL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Terry Vail, OD is a certified Optometrist practicing in Macomb, IL. With approximately 57 years of clinical experience since completing medical education in 1969, Dr. Vail delivers high-quality medical care to the local community at 131 S RANDOLPH ST.

Dr. Vail accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, photography of the retina, established patient problem focused exam of visual system. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

131 S Randolph St

Macomb, IL 614552207

Telephone 3098335557

Associated Practice Facility / Clinic

🏢 Vision Consultants Ltd Facility NPI 1699963850

Medicare Profile & Education

Medical School

Other

Graduation Year

1969

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Macomb, IL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

57 Yrs +26.5 yrs vs City Avg

City Avg: 30.5 Yrs

State Avg: 22.8 Yrs

Regional Practice Density

8 Specialists

Practicing in Macomb, IL (2783 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

31.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Vail (57 Years) 57 Yrs

Macomb Specialty Average (30.5 Years) 30.5 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	71	69	$93.00	$86.71
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	37	27	$58.00	$53.53
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	22	22	$139.86	$122.87
92250 Photography of the retina	20	19	$107.00	$33.51
92012 Established patient problem focused exam of visual system	20	19	$105.00	$82.73
92014 Established patient complete exam of visual system	19	19	$158.89	$117.02
92285 Photography of content of eyes	19	19	$61.00	$21.38
92133 Imaging of optic nerve	12	11	$46.00	$20.09
92083 Exam of visual field with extended testing	11	11	$104.00	$58.34

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	44	42	$93.00	$86.68
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	30	30	$137.00	$122.83
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	25	19	$58.00	$53.92
92250 Photography of the retina	22	21	$107.00	$33.45
92012 Established patient problem focused exam of visual system	21	19	$105.00	$84.46
92014 Established patient complete exam of visual system	18	17	$158.00	$118.81
92285 Photography of content of eyes	17	17	$61.00	$20.96
92134 Imaging of retina	13	12	$51.54	$23.65

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	40	28	$57.85	$54.59
99213 Established patient office or other outpatient visit, typically 15 minutes	39	38	$93.00	$88.05
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	32	32	$137.00	$124.13
92014 Established patient complete exam of visual system	24	23	$158.00	$120.92
92285 Photography of content of eyes	23	23	$61.00	$21.43
92250 Photography of the retina	21	21	$107.00	$33.24
92012 Established patient problem focused exam of visual system	19	17	$99.53	$80.89
92133 Imaging of optic nerve	16	14	$46.00	$20.95
92083 Exam of visual field with extended testing	14	12	$104.00	$59.03

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	56	54	$93.00	$89.26
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	48	47	$138.31	$126.87
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	33	25	$58.00	$54.49
92012 Established patient problem focused exam of visual system	25	21	$105.00	$86.26
92014 Established patient complete exam of visual system	25	25	$158.00	$121.94
92250 Photography of the retina	23	22	$104.35	$35.92
92134 Imaging of retina	20	20	$51.95	$24.71
92133 Imaging of optic nerve	17	16	$46.00	$21.37
92083 Exam of visual field with extended testing	17	15	$104.18	$60.28
92285 Photography of content of eyes	16	16	$61.00	$21.43

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	68	61	$93.00	$73.34
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	39	39	$137.54	$106.50
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	38	25	$58.00	$44.14
92012 Established patient problem focused exam of visual system	37	31	$105.00	$85.16
92014 Established patient complete exam of visual system	26	25	$158.00	$121.76
92250 Photography of the retina	23	23	$107.00	$42.76
92285 Photography of content of eyes	17	17	$61.00	$18.69
92083 Exam of visual field with extended testing	17	15	$104.00	$60.33
92134 Imaging of retina	16	16	$52.00	$25.09
92133 Imaging of optic nerve	12	12	$46.00	$22.05

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	103	96	$93.00	$71.74
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	44	30	$58.00	$43.23
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	44	43	$137.95	$105.24
92250 Photography of the retina	41	39	$107.00	$47.25
92012 Established patient problem focused exam of visual system	39	32	$105.00	$84.23
92014 Established patient complete exam of visual system	31	29	$158.00	$121.27
92134 Imaging of retina	24	22	$52.00	$26.38
92285 Photography of content of eyes	20	20	$61.00	$18.19
92133 Imaging of optic nerve	18	16	$46.00	$21.81
92083 Exam of visual field with extended testing	16	15	$100.78	$60.12

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	75	68	$93.00	$68.60
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	58	34	$58.00	$40.94
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	38	37	$137.00	$101.27
92012 Established patient problem focused exam of visual system	33	28	$105.00	$81.44
92250 Photography of the retina	30	30	$107.00	$51.44
92014 Established patient complete exam of visual system	29	29	$158.00	$117.37
92083 Exam of visual field with extended testing	20	15	$104.60	$59.09
92133 Imaging of optic nerve	19	17	$46.00	$24.35
92285 Photography of content of eyes	13	13	$61.00	$17.00
92134 Imaging of retina	13	13	$55.00	$25.83

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
66984 Removal of cataract with insertion of lens	1,599	16	$5.00	$1.29
99213 Established patient office or other outpatient visit, typically 15 minutes	62	56	$93.00	$65.81
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	43	32	$58.00	$39.01
92014 Established patient complete exam of visual system	43	41	$158.00	$110.13
92012 Established patient problem focused exam of visual system	39	37	$106.03	$75.94
92250 Photography of the retina	28	28	$107.00	$57.58
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	26	24	$137.00	$97.32
92285 Photography of content of eyes	15	15	$61.00	$17.25

Medical Specialties & State Licenses

CMS Verified: 2024-08-16

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License IL 0046 6378

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

046006378 (IL)

Commercial Insurance / Payer ID Federal Tax Id

371036657

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

📍

Updated Practice Location August 16, 2024

Registered at 131 S RANDOLPH ST, MACOMB, IL 614552207 (Tel: 3098335557)

✅

NPI Profile Active March 11, 2008

NPI status registered as active in NPPES database

📍

Updated Practice Location March 11, 2008

Registered at 119 S SIDE SQ, MACOMB, IL 614552218 (Tel: 3098335557)

📍

Updated Business Mailing Address March 11, 2008

Registered at PO BOX 398, MACOMB, IL 614550398 (Tel: 3098335557)

👤

Provider Name / Credentials Updated March 11, 2008

Recorded as TERRY VAIL, O.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 11, 2008

Optometrist (License #0046 6378 in IL)

🟢

Initial NPI Registration & Enumeration November 18, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1063494532

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: November 18, 2005

Last Update: August 16, 2024

Sole Proprietor: No

Update or Correct Profile

Mailing Address

Po Box 398

Macomb, IL 614550398

Phone: 3098335557

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.