Sussex Eye Center PA
Sussex Eye Center PA was paid $851K by Medicaid between Jan 2018 and Dec 2024, across 33 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 33% of everything it billed.
33Billing provider infoSUSSEX EYE CENTER PA
GEORGETOWN, DE 19947
GEORGETOWN, DE 19947
33aNPI1427090570assigned 06/12/2006
33bProvider typeOptometrist
28Total paid$851K
24GClaims28,770
24DCodes billed33
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Optometrist providers in Delaware
Rank by total paid#4 of 61
Median peer was paid$31K
This provider vs. median27×
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
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 | |
|---|---|---|---|
| 2018 | 4,264 | $6K | |
| 2019 | 5,266 | $55K | |
| 2020 | 1,798 | $64K | |
| 2021 | 3,914 | $144K | |
| 2022 | 5,652 | $257K | |
| 2023 | 4,550 | $197K | |
| 2024incomplete | 3,326 | $128K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 33% | 4,150 | 3,693 | $285K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 13% | 1,470 | 1,348 | $109K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 12% | 2,376 | 1,962 | $105K |
| V2020 | Frames, purchases | 10% | 2,306 | 1,987 | $89K |
| 92015 | Determination of refractive state | 8.5% | 6,528 | 5,805 | $72K |
| S0621 | Routine ophthalmological examination including refraction; established patient | 6.1% | 892 | 782 | $52K |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 3.8% | 1,230 | 1,025 | $32K |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 3.3% | 1,036 | 835 | $28K |
| 92250 | 3.0% | 993 | 852 | $25K | |
| S0620 | Routine ophthalmological examination including refraction; new patient | 1.8% | 261 | 240 | $15K |
| 92133 | 1.3% | 491 | 419 | $11K | |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | <1% | 190 | 156 | $7K |
21 more codes
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | <1% | 305 | $6K |
| 92065 | <1% | 183 | $5K | |
| 92060 | <1% | 75 | $3K | |
| S0500 | Disposable contact lens, per lens | <1% | 16 | $2K |
| V2203 | Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | <1% | 28 | $1K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 58 | $725.99 |
| V2104 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens | <1% | 13 | $331.33 |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 13 | $266.38 |
| G9903 | Patient screened for tobacco use and identified as a tobacco non-user | 0% | 746 | $0.00 |
| G8428 | Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given | 0% | 301 | $0.00 |
| 1036F | 0% | 964 | $0.00 | |
| G8397 | Dilated macular or fundus exam performed, including documentation of the presence or absence of macular edema and level of severity of retinopathy | 0% | 23 | $0.00 |
| G8950 | Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented | 0% | 13 | $0.00 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 1,459 | $0.00 |
| G9744 | Patient not eligible due to active diagnosis of hypertension | 0% | 186 | $0.00 |
| G8731 | Pain assessment using a standardized tool is documented as negative, no follow-up plan required | 0% | 1,514 | $0.00 |
| G8783 | Normal blood pressure reading documented, follow-up not required | 0% | 842 | $0.00 |
| 2027F | 0% | 33 | $0.00 | |
| 5010F | 0% | 23 | $0.00 | |
| 2022F | 0% | 22 | $0.00 | |
| G8442 | Pain assessment not documented as being performed, documentation the patient is not eligible for a pain assessment using a standardized tool at the time of the encounter | 0% | 30 | $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 officialMASCHAUER, CARL (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| ST Croix Vision Center INC | Christiansted, VI | $3.57M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.