Efrain Mascareno Od Apc
Efrain Mascareno Od Apc was paid $1.51M by Medicaid between Jan 2018 and Nov 2024, across 16 billing codes. Its largest line is 92004, Ophthalmological services: medical examination and evaluation, comprehensive, new patient — 26% of everything it billed.
33Billing provider infoEFRAIN MASCARENO OD APC
CHULA VISTA, CA 91910
CHULA VISTA, CA 91910
33aNPI1073687851assigned 11/20/2006
33bProvider typeOptometrist
28Total paid$1.51M
24GClaims65,922
24DCodes billed16
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Optometrist providers in California
Rank by total paid#46 of 1,899
Median peer was paid$23K
This provider vs. median67×
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 | 8,338 | $126K | |
| 2019 | 5,402 | $73K | |
| 2020 | 6,380 | $114K | |
| 2021 | 10,319 | $209K | |
| 2022 | 11,610 | $328K | |
| 2023 | 15,697 | $506K | |
| 2024incomplete | 8,176 | $152K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 26% | 9,976 | 9,952 | $385K |
| V2020 | Frames, purchases | 23% | 12,739 | 12,710 | $347K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 15% | 8,679 | 8,665 | $233K |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | 8.1% | 9,320 | 9,312 | $121K |
| 92015 | Determination of refractive state | 7.4% | 18,617 | 18,574 | $111K |
| V2750 | Anti-reflective coating, per lens | 7.3% | 930 | 927 | $110K |
| V2200 | Sphere, bifocal, plano to plus or minus 4.00d, per lens | 5.8% | 1,352 | 682 | $87K |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 3.5% | 1,860 | 940 | $53K |
| 92341 | 1.9% | 1,460 | 1,459 | $29K | |
| 92201 | <1% | 600 | 598 | $14K | |
| 92250 | <1% | 209 | 209 | $9K | |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | <1% | 86 | 43 | $5K |
4 more codes
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 officialMASCARENO, EFRAIN (PRESIDENT)