1457817405

1457817405 was paid $826K by Medicaid between Jun 2021 and Jul 2024, across 16 billing codes. Its largest line is 92014, Ophthalmological services: medical examination and evaluation, comprehensive, established patient — 36% of everything it billed.

33Billing provider info1457817405

33aNPI1457817405

33bProvider type—

28Total paid$826K

24GClaims24,193

24DCodes billed16

24AFirst – last monthJun 2021 – Jul 2024

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
2021	3,773	$105K
2022	6,113	$192K
2023	10,142	$362K
2024incomplete	4,165	$167K

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	36%	3,269	3,100	$295K
92004	Ophthalmological services: medical examination and evaluation, comprehensive, new patient	19%	1,438	1,360	$157K
V2410	Variable asphericity lens, single vision, full field, glass or plastic, per lens	11%	1,322	573	$95K
V2020	Frames, purchases	9.1%	1,806	1,570	$75K
V2784	Lens, polycarbonate or equal, any index, per lens	5.7%	3,727	1,609	$47K
V2750	Anti-reflective coating, per lens	5.3%	3,182	1,393	$44K
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	4.9%	1,585	833	$40K
92340	Fitting of spectacles, except for aphakia; monofocal	4.3%	1,785	1,554	$35K
92310		1.4%	673	649	$12K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	1.2%	205	178	$10K
V2104	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens	<1%	239	148	$7K
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	<1%	139	65	$3K

4 more codes

V2521	Contact lens, hydrophilic, toric, or prism ballast, per lens	<1%	26	$2K
92015	Determination of refractive state	<1%	4,738	$2K
V2107	Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens	<1%	29	$876.82
V2745	Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens	<1%	30	$153.16

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.