1093737850

1093737850 was paid $63K by Medicaid between Feb 2019 and Jun 2023, across 13 billing codes. Its largest line is 92004, Ophthalmological services: medical examination and evaluation, comprehensive, new patient — 39% of everything it billed.

33Billing provider info1093737850

33aNPI1093737850

33bProvider type—

28Total paid$63K

24GClaims6,131

24DCodes billed13

24AFirst – last monthFeb 2019 – Jun 2023

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
2019	2,792	$11K
2020	1,254	$9K
2021	520	$13K
2022	1,184	$23K
2023	381	$7K

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	39%	933	910	$24K
92014	Ophthalmological services: medical examination and evaluation, comprehensive, established patient	28%	401	395	$18K
V2104	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens	21%	151	145	$13K
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	7.7%	61	33	$5K
92340	Fitting of spectacles, except for aphakia; monofocal	3.2%	717	706	$2K
92015	Determination of refractive state	1.2%	1,180	1,159	$764.97
V2020	Frames, purchases	<1%	926	887	$405.80
92341		<1%	12	12	$104.10
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	<1%	221	124	$11.00
92342		0%	367	367	$0.00
V2756	Eye glass case	0%	367	367	$0.00
2021F		0%	396	396	$0.00

1 more codes

G0117

Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist

399

$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.