THEOBALD FAMILY EYE CARE, LLP
NPI: 1326133497
· DULUTH, MN 55807
· 152W00000X
$318K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,198 |
$5K |
| 2019 |
1,287 |
$42K |
| 2020 |
1,216 |
$44K |
| 2021 |
1,666 |
$61K |
| 2022 |
1,238 |
$47K |
| 2023 |
1,638 |
$66K |
| 2024 |
1,331 |
$53K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
2,008 |
1,952 |
$149K |
| 92015 |
|
4,082 |
3,966 |
$48K |
| 92004 |
|
508 |
498 |
$45K |
| 92340 |
|
1,878 |
1,815 |
$44K |
| V2020 |
Vision svcs frames purchases |
731 |
658 |
$21K |
| 92341 |
|
292 |
284 |
$9K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
25 |
25 |
$2K |
| 92250 |
|
38 |
37 |
$940.40 |
| S0580 |
Polycarb lens |
12 |
12 |
$119.37 |