1285643460

1285643460 was paid $199K by Medicaid between Jan 2018 and Nov 2021, across 6 billing codes. Its largest line is S0620, Routine ophthalmological examination including refraction; new patient — 41% of everything it billed.

33Billing provider info1285643460

33aNPI1285643460

33bProvider type—

28Total paid$199K

24GClaims5,856

24DCodes billed6

24AFirst – last monthJan 2018 – Nov 2021

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	1,099	$47K
2019	1,765	$57K
2020	1,280	$41K
2021	1,712	$54K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
S0620	Routine ophthalmological examination including refraction; new patient	41%	1,771	1,770	$81K
92004	Ophthalmological services: medical examination and evaluation, comprehensive, new patient	27%	1,266	1,247	$54K
S0621	Routine ophthalmological examination including refraction; established patient	24%	923	923	$48K
92014	Ophthalmological services: medical examination and evaluation, comprehensive, established patient	5.9%	275	272	$12K
92015	Determination of refractive state	2.1%	274	267	$4K
3072F		<1%	1,347	1,347	$240.00

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.