Sunga, Epifanio
Sunga, Epifanio was paid $17K by Medicaid between Jan 2018 and Apr 2024, across 9 billing codes. Its largest line is 92014, Ophthalmological services: medical examination and evaluation, comprehensive, established patient — 77% of everything it billed.
33Billing provider infoSUNGA, EPIFANIO
TOMS RIVER, NJ 08753
TOMS RIVER, NJ 08753
33aNPI1457362055assigned 08/10/2006
33bProvider typeOptometrist
28Total paid$17K
24GClaims2,143
24DCodes billed9
24AFirst – last monthJan 2018 – Apr 2024
Compared with peers
Next to other Optometrist providers in New Jersey
Rank by total paid#199 of 599
Median peer was paid$2K
This provider vs. median9.4×
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 | 1,116 | $6K | |
| 2019 | 415 | $3K | |
| 2020 | 149 | $2K | |
| 2021 | 138 | $2K | |
| 2022 | 102 | $2K | |
| 2023 | 184 | $2K | |
| 2024incomplete | 39 | $643.40 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 77% | 713 | 681 | $13K |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | 9.3% | 131 | 131 | $2K |
| 92015 | Determination of refractive state | 8.4% | 675 | 642 | $1K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 3.6% | 57 | 57 | $611.60 |
| V2020 | Frames, purchases | 1.3% | 371 | 368 | $220.00 |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | <1% | 106 | 100 | $84.00 |
| S0621 | Routine ophthalmological examination including refraction; established patient | 0% | 15 | 15 | $0.00 |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 0% | 49 | 26 | $0.00 |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 0% | 26 | 13 | $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.