Supplier
Michael L Sussex Od PC
Michael L Sussex Od PC was paid $292K by Medicaid between Jan 2018 and Feb 2019, across 22 billing codes. Its largest line is V2020, Frames, purchases — 23% of everything it billed.
33Billing provider infoMICHAEL L SUSSEX OD PC
COLDWATER, MI 49036
COLDWATER, MI 49036
33aNPI1104864313assigned 06/02/2006
33bProvider typeEyewear Supplier
28Total paid$292K
24GClaims12,587
24DCodes billed22
24AFirst – last monthJan 2018 – Feb 2019
Compared with peers
Next to other Eyewear Supplier providers in Michigan
Rank by total paid#16 of 92
Median peer was paid$13K
This provider vs. median22×
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 | 12,343 | $287K | |
| 2019 | 244 | $5K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| V2020 | Frames, purchases | 23% | 2,153 | 2,093 | $66K |
| S0621 | Routine ophthalmological examination including refraction; established patient | 15% | 930 | 916 | $45K |
| S0620 | Routine ophthalmological examination including refraction; new patient | 12% | 803 | 791 | $36K |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | 12% | 1,814 | 1,767 | $35K |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 8.5% | 1,182 | 1,156 | $25K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 5.6% | 281 | 275 | $16K |
| 92341 | 4.0% | 518 | 509 | $12K | |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 3.0% | 116 | 113 | $9K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 2.8% | 175 | 174 | $8K |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 2.8% | 1,711 | 1,673 | $8K |
| 92015 | Determination of refractive state | 2.5% | 685 | 674 | $7K |
| V2203 | Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 2.5% | 309 | 302 | $7K |
10 more codes
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 2.4% | 423 | $7K |
| V2104 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens | 1.0% | 139 | $3K |
| 99213 | Doctor's office visit, returning patient (routine) | 1.0% | 72 | $3K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 14 | $1K |
| 92250 | <1% | 51 | $1K | |
| V2200 | Sphere, bifocal, plano to plus or minus 4.00d, per lens | <1% | 66 | $988.89 |
| V2107 | Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens | <1% | 29 | $337.30 |
| V2715 | Prism, per lens | <1% | 59 | $302.20 |
| V2756 | Eye glass case | <1% | 396 | $88.56 |
| 1036F | 0% | 661 | $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 officialSUSSEX, MICHAEL (PRESIDENT)
Parent organizationMICHAEL L SUSSEX OD PC
| Provider | Location | Paid |
|---|---|---|
| Three Rivers Eyecare PC | Three Rivers, MI | $110K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.