Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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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
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

$0$2.5K$5.0K$7.5K2018201920202021202220232024
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
YearClaimsPaid
201946$953.12
2020131$5K
2021252$10K
2022430$25K
2023364$24K
2024incomplete217$16K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
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)