1255385753

1255385753 was paid $473K by Medicaid between Jan 2018 and Feb 2024, across 15 billing codes. Its largest line is 92014, Ophthalmological services: medical examination and evaluation, comprehensive, established patient — 32% of everything it billed.

33Billing provider info1255385753

33aNPI1255385753

33bProvider type—

28Total paid$473K

24GClaims18,083

24DCodes billed15

24AFirst – last monthJan 2018 – Feb 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
2018	4,926	$132K
2019	4,530	$109K
2020	2,632	$67K
2021	2,658	$75K
2022	1,812	$51K
2023	1,326	$34K
2024incomplete	199	$5K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
92014	Ophthalmological services: medical examination and evaluation, comprehensive, established patient	32%	2,153	1,988	$153K
92004	Ophthalmological services: medical examination and evaluation, comprehensive, new patient	25%	1,434	1,309	$120K
V2020	Frames, purchases	12%	3,950	3,552	$57K
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	8.1%	3,071	2,804	$38K
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	5.0%	1,350	1,206	$24K
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	4.9%	1,475	1,343	$23K
92060		4.8%	628	555	$23K
92015	Determination of refractive state	3.7%	2,945	2,669	$18K
S0580	Polycarbonate lens (list this code in addition to the basic code for the lens)	3.0%	315	278	$14K
92340	Fitting of spectacles, except for aphakia; monofocal	<1%	135	119	$1K
V2799	Vision item or service, miscellaneous	<1%	49	46	$637.26
V2104	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens	<1%	41	39	$556.10

3 more codes

V2107	Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens	<1%	15	$265.68
2026F		0%	508	$0.00
3072F		0%	14	$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.