Summerville Pediatric Eyecare PC
Summerville Pediatric Eyecare PC was paid $242K by Medicaid between Feb 2020 and Oct 2024, across 11 billing codes. Its largest line is 92004, Ophthalmological services: medical examination and evaluation, comprehensive, new patient — 47% of everything it billed.
33Billing provider infoSUMMERVILLE PEDIATRIC EYECARE PC
SUMMERVILLE, SC 29483
SUMMERVILLE, SC 29483
33aNPI1114490976assigned 01/04/2019
33bProvider typePediatric Optometrist
28Total paid$242K
24GClaims7,223
24DCodes billed11
24AFirst – last monthFeb 2020 – Oct 2024
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 | |
|---|---|---|---|
| 2020 | 607 | $21K | |
| 2021 | 1,311 | $40K | |
| 2022 | 2,696 | $89K | |
| 2023 | 2,075 | $74K | |
| 2024incomplete | 534 | $18K |
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 | 47% | 1,379 | 1,363 | $115K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 17% | 566 | 559 | $41K |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | 15% | 1,828 | 1,773 | $38K |
| 92015 | Determination of refractive state | 9.8% | 2,223 | 2,182 | $24K |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 5.9% | 778 | 740 | $14K |
| 92310 | 2.0% | 89 | 89 | $5K | |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 1.7% | 272 | 215 | $4K |
| V2025 | Deluxe frame | <1% | 12 | 12 | $819.00 |
| 92082 | <1% | 26 | 24 | $754.00 | |
| 92250 | <1% | 17 | 17 | $490.87 | |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | <1% | 33 | 27 | $194.25 |
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 officialMCCARTNEY, KELLI (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Remote Optometric Services LLC | Manning, SC | $16K |
| Summerville Primary Eyecare LLC | Summerville, SC | $10K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.