Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

OPTICAL GALLERY INC

NPI: 1487729026 · WASHINGTON, DC 20036 · Optometrist · NPI assigned 11/21/2006

$3K
Total Medicaid Paid
184
Total Claims
184
Beneficiaries
5
Codes Billed
2020-07
First Month
2022-08
Last Month

Provider Details

Authorized OfficialKHALIL, SAM (MANAGER)
NPI Enumeration Date11/21/2006

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 37 $700.00
2021 26 $480.00
2022 121 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient 37 37 $1K
V2100 Sphere, single vision, plano to plus or minus 4.00, per lens 40 40 $914.80
V2020 Frames, purchases 26 26 $520.00
V2784 Lens, polycarbonate or equal, any index, per lens 28 28 $185.56
92015 Determination of refractive state 53 53 $0.00