1154453462

1154453462 was paid $264K by Medicaid between Jan 2018 and Dec 2019, across 11 billing codes. Its largest line is V2100, Sphere, single vision, plano to plus or minus 4.00, per lens — 32% of everything it billed.

33Billing provider info1154453462

33aNPI1154453462

33bProvider type—

28Total paid$264K

24GClaims7,379

24DCodes billed11

24AFirst – last monthJan 2018 – Dec 2019

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	4,148	$172K
2019	3,231	$92K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	32%	1,712	1,192	$85K
V2200	Sphere, bifocal, plano to plus or minus 4.00d, per lens	25%	487	363	$67K
V2025	Deluxe frame	19%	1,726	1,276	$50K
92340	Fitting of spectacles, except for aphakia; monofocal	17%	1,681	1,627	$45K
V2020	Frames, purchases	3.7%	614	485	$10K
92341		1.6%	178	168	$4K
V2784	Lens, polycarbonate or equal, any index, per lens	<1%	664	638	$2K
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	<1%	253	236	$1K
V2203	Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	<1%	15	15	$135.00
V2104	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens	<1%	18	18	$77.00
S0581	Nonstandard lens (list this code in addition to the basic code for the lens)	0%	31	31	$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.