PURE VISION OPTICAL LLC
NPI: 1033717053
· FOREST HILLS, NY 11375
· 152W00000X
$222K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
1,381 |
$53K |
| 2022 |
1,263 |
$55K |
| 2023 |
2,185 |
$85K |
| 2024 |
838 |
$30K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
|
1,089 |
1,085 |
$72K |
| 92250 |
|
1,453 |
1,436 |
$60K |
| 68761 |
|
274 |
136 |
$20K |
| 92285 |
|
735 |
719 |
$19K |
| V2100 |
Lens spher single plano 4.00 |
673 |
347 |
$14K |
| 99213 |
|
369 |
341 |
$13K |
| 92014 |
|
225 |
225 |
$12K |
| V2020 |
Vision svcs frames purchases |
423 |
419 |
$7K |
| 92060 |
|
107 |
107 |
$4K |
| 92012 |
|
26 |
25 |
$1K |
| 92083 |
|
13 |
13 |
$616.53 |
| 92133 |
|
13 |
13 |
$360.24 |
| 92340 |
|
17 |
17 |
$340.00 |
| V2784 |
Lens polycarb or equal |
250 |
123 |
$0.00 |