Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
Home › MO › Cape Girardeau › NPI 1417428509

Success Vision Eyecare of Cape, LLC

Success Vision Eyecare of Cape, LLC was paid $138K by Medicaid between Nov 2019 and Nov 2024, across 11 billing codes. Its largest line is 92004, Ophthalmological services: medical examination and evaluation, comprehensive, new patient — 33% of everything it billed.

33Billing provider infoSUCCESS VISION EYECARE OF CAPE, LLC
CAPE GIRARDEAU, MO 63703
33aNPI1417428509assigned 12/16/2018
33bProvider typeOptometrist
28Total paid$138K
24GClaims6,449
24DCodes billed11
24AFirst – last monthNov 2019 – Nov 2024
Compared with peers

Next to other Optometrist providers in Missouri

Rank by total paid#69 of 547
Median peer was paid$19K
This provider vs. median7.3×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

$0$5.0K$10K2018201920202021202220232024
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
2019168$849.32
2020758$4K
2021964$7K
20221,086$20K
20231,896$62K
2024incomplete1,577$45K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient 33% 453 450 $45K
99214 Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 20% 353 302 $28K
92015 Determination of refractive state 9.6% 3,484 3,362 $13K
92082 8.4% 690 654 $12K
92002 8.4% 185 181 $12K
92250 6.8% 687 646 $9K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient 4.9% 89 89 $7K
92012 Ophthalmological services: medical examination and evaluation, intermediate, established patient 3.9% 94 89 $5K
99204 Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 3.7% 53 50 $5K
99203 Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity 1.7% 225 213 $2K
99072 0% 136 131 $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.

From NPPES

Who's on the registration

Authorized officialDAVYDOVA, ROSE (AUTHORIZED OFFICIAL)
Same official

Other billing entities under DAVYDOVA, ROSE

Full network →
ProviderLocationPaid
Success Vision Express of Tulsa, LLCTulsa, OK$3.15M
Success Vision Express of Sand Springs, LLCSand Springs, OK$1.52M
Sve Management of Manhattan, LLCManhattan, KS$8K

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.