Clinic
Ideal Vision Center LLC
Ideal Vision Center LLC was paid $81K by Medicaid between Nov 2019 and Oct 2024, across 2 billing codes. Its largest line is V2199, Not otherwise classified, single vision lens — 78% of everything it billed.
33Billing provider infoIDEAL VISION CENTER LLC
HAGATNA, GU 96910
HAGATNA, GU 96910
33aNPI1316103609assigned 08/06/2008
33bProvider typeClinic/Center
28Total paid$81K
24GClaims1,440
24DCodes billed2
24AFirst – last monthNov 2019 – 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 | |
|---|---|---|---|
| 2019 | 46 | $953.12 | |
| 2020 | 131 | $5K | |
| 2021 | 252 | $10K | |
| 2022 | 430 | $25K | |
| 2023 | 364 | $24K | |
| 2024incomplete | 217 | $16K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| V2199 | Not otherwise classified, single vision lens | 78% | 517 | 504 | $63K |
| 92015 | Determination of refractive state | 22% | 923 | 905 | $18K |
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 officialSUNGA, LORRAINE (VICE-PRESIDENT/MANAGER)