1093869257

1093869257 was paid $737K by Medicaid between Jan 2018 and Aug 2021, across 24 billing codes. Its largest line is 92015, Determination of refractive state — 22% of everything it billed.

33Billing provider info1093869257

33aNPI1093869257

33bProvider type—

28Total paid$737K

24GClaims45,537

24DCodes billed24

24AFirst – last monthJan 2018 – Aug 2021

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	10,783	$166K
2019	15,872	$251K
2020	8,265	$140K
2021	10,617	$181K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
92015	Determination of refractive state	22%	14,471	14,428	$159K
11721		19%	6,454	6,423	$142K
92014	Ophthalmological services: medical examination and evaluation, comprehensive, established patient	17%	8,620	8,611	$125K
92341		16%	5,337	5,321	$120K
92004	Ophthalmological services: medical examination and evaluation, comprehensive, new patient	8.2%	2,976	2,962	$61K
11056		6.9%	1,614	1,604	$51K
92340	Fitting of spectacles, except for aphakia; monofocal	2.2%	825	822	$16K
92557		2.0%	756	753	$15K
99304		1.8%	305	301	$13K
11730		1.7%	233	233	$13K
G0127	Trimming of dystrophic nails, any number	<1%	1,428	1,428	$7K
99307		<1%	205	205	$4K

12 more codes

92250		<1%	1,123	$4K
11055		<1%	147	$3K
92285		<1%	500	$2K
92553		<1%	24	$506.84
11720		<1%	41	$500.12
99308	Subsequent nursing facility care, per day, straightforward	<1%	29	$319.03
67820		<1%	79	$211.40
76514		<1%	158	$180.18
92225		<1%	19	$91.50
92020		<1%	13	$60.24
92226		<1%	14	$28.14
65210		0%	166	$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.