Managed care
Designer Optical of Pelham
Designer Optical of Pelham was paid $159K by Medicaid between Jan 2018 and Jan 2021, across 12 billing codes. Its largest line is V2783, Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens — 43% of everything it billed.
33Billing provider infoDESIGNER OPTICAL OF PELHAM
BRONX, NY 10462
BRONX, NY 10462
33aNPI1548431521assigned 03/18/2008
33bProvider typeHealth Maintenance Organization
28Total paid$159K
24GClaims7,229
24DCodes billed12
24AFirst – last monthJan 2018 – Jan 2021
Compared with peers
Next to other Health Maintenance Organization providers in New York
Rank by total paid#15 of 28
Median peer was paid$159K
This provider vs. median1.0×
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 | 1,570 | $94K | |
| 2019 | 2,352 | $37K | |
| 2020 | 3,277 | $28K | |
| 2021 | 30 | $367.50 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| V2783 | Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens | 43% | 460 | 460 | $68K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 28% | 1,132 | 1,129 | $44K |
| V2020 | Frames, purchases | 13% | 2,129 | 2,105 | $20K |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 6.5% | 1,596 | 824 | $10K |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | 4.3% | 517 | 517 | $7K |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 3.2% | 686 | 529 | $5K |
| V2200 | Sphere, bifocal, plano to plus or minus 4.00d, per lens | 1.9% | 272 | 136 | $3K |
| 92002 | <1% | 136 | 135 | $1K | |
| V2203 | Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | <1% | 37 | 28 | $380.85 |
| 92341 | <1% | 14 | 14 | $252.00 | |
| S0580 | Polycarbonate lens (list this code in addition to the basic code for the lens) | <1% | 14 | 14 | $126.00 |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 0% | 236 | 118 | $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 officialCHOAI, ABRAHAM (PRES)