For Eyes Optical of PA

For Eyes Optical of PA was paid $5K by Medicaid between Jan 2018 and Jun 2019, across 5 billing codes. Its largest line is V2100, Sphere, single vision, plano to plus or minus 4.00, per lens — 42% of everything it billed.

33Billing provider infoFOR EYES OPTICAL OF PA
CALUMET CITY, IL 60409

33aNPI1053469601assigned 01/08/2007

33bProvider typeEyewear Supplier

28Total paid$5K

24GClaims282

24DCodes billed5

24AFirst – last monthJan 2018 – Jun 2019

Compared with peers

Next to other Eyewear Supplier providers in Illinois

Rank by total paid#53 of 71

Median peer was paid$27K

This provider vs. median0.2×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2018	104	$2K
2019	178	$3K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	42%	93	90	$2K
V2020	Frames, purchases	31%	105	105	$1K
92340	Fitting of spectacles, except for aphakia; monofocal	16%	51	50	$710.00
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	11%	16	16	$487.50
V2025	Deluxe frame	0%	17	17	$0.00

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialCOSTA, JOSE (CEO)

Same official

Other billing entities under COSTA, JOSE

Full network →

Provider	Location	Paid
For Eyes Optical of Puerto Rico, LLC	Mayaguez, PR	$4K

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.