1326004953

1326004953 was paid $208K by Medicaid between Jan 2019 and Jan 2023, across 13 billing codes. Its largest line is 92004, Ophthalmological services: medical examination and evaluation, comprehensive, new patient — 42% of everything it billed.

33Billing provider info1326004953

33aNPI1326004953

33bProvider type—

28Total paid$208K

24GClaims11,769

24DCodes billed13

24AFirst – last monthJan 2019 – Jan 2023

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	2,960	$54K
2020	1,421	$25K
2021	2,832	$51K
2022	4,524	$78K
2023	32	$109.50

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
92004	Ophthalmological services: medical examination and evaluation, comprehensive, new patient	42%	1,078	1,022	$87K
92014	Ophthalmological services: medical examination and evaluation, comprehensive, established patient	36%	1,353	1,286	$75K
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	11%	1,427	1,301	$22K
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	5.2%	726	662	$11K
92340	Fitting of spectacles, except for aphakia; monofocal	3.5%	2,320	2,168	$7K
V2020	Frames, purchases	2.1%	2,146	2,002	$4K
92015	Determination of refractive state	<1%	2,233	2,119	$539.00
V2784	Lens, polycarbonate or equal, any index, per lens	<1%	120	115	$28.00
V2025	Deluxe frame	0%	313	294	$0.00
2021F		0%	13	13	$0.00
92342		0%	12	12	$0.00
V2104	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens	0%	16	12	$0.00

1 more codes

V2756

Eye glass case

$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.