SUMMERVILLE PEDIATRIC EYECARE PC
NPI: 1114490976
· SUMMERVILLE, SC 29483
· 152WP0200X
$242K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
607 |
$21K |
| 2021 |
1,311 |
$40K |
| 2022 |
2,696 |
$89K |
| 2023 |
2,075 |
$74K |
| 2024 |
534 |
$18K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
|
1,379 |
1,363 |
$115K |
| 92014 |
|
566 |
559 |
$41K |
| 92340 |
|
1,828 |
1,773 |
$38K |
| 92015 |
|
2,223 |
2,182 |
$24K |
| V2784 |
Lens polycarb or equal |
778 |
740 |
$14K |
| 92310 |
|
89 |
89 |
$5K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
272 |
215 |
$4K |
| V2025 |
Eyeglasses delux frames |
12 |
12 |
$819.00 |
| 92082 |
|
26 |
24 |
$754.00 |
| 92250 |
|
17 |
17 |
$490.87 |
| V2100 |
Lens spher single plano 4.00 |
33 |
27 |
$194.25 |