JACKSON DAVENPORT VISION, INC.
NPI: 1184719387
· SUMMERVILLE, SC 29485
· 152W00000X
$425K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,006 |
$61K |
| 2019 |
2,276 |
$68K |
| 2020 |
1,780 |
$55K |
| 2021 |
2,418 |
$71K |
| 2022 |
2,665 |
$77K |
| 2023 |
1,500 |
$52K |
| 2024 |
1,249 |
$41K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
|
1,698 |
1,665 |
$135K |
| 92014 |
|
1,930 |
1,919 |
$133K |
| 92340 |
|
4,349 |
4,289 |
$74K |
| 92015 |
|
3,683 |
3,646 |
$50K |
| V2020 |
Vision svcs frames purchases |
371 |
369 |
$17K |
| V2784 |
Lens polycarb or equal |
1,069 |
523 |
$11K |
| V2100 |
Lens spher single plano 4.00 |
794 |
394 |
$5K |