PRESQUE ISLE OPTIQUE LLC
NPI: 1104103456
· ERIE, PA 16501
· 156F00000X
$155K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
233 |
$9K |
| 2021 |
1,130 |
$41K |
| 2022 |
1,389 |
$49K |
| 2023 |
1,174 |
$36K |
| 2024 |
895 |
$20K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Lens spher single plano 4.00 |
1,529 |
860 |
$58K |
| V2020 |
Vision svcs frames purchases |
1,144 |
1,033 |
$39K |
| 92004 |
|
755 |
735 |
$31K |
| 92014 |
|
316 |
310 |
$13K |
| 92012 |
|
237 |
236 |
$9K |
| V2025 |
Eyeglasses delux frames |
155 |
150 |
$2K |
| V2784 |
Lens polycarb or equal |
398 |
168 |
$1K |
| V2523 |
Cntct lens hydrophil extend |
12 |
12 |
$986.00 |
| V2200 |
Lens spher bifoc plano 4.00d |
17 |
13 |
$981.33 |
| 92015 |
|
258 |
245 |
$60.00 |