Custom Eyes Optometry, INC.
Custom Eyes Optometry, INC. was paid $23K by Medicaid between Jan 2018 and Jul 2020, across 5 billing codes. Its largest line is 92004, Ophthalmological services: medical examination and evaluation, comprehensive, new patient — 45% of everything it billed.
33Billing provider infoCUSTOM EYES OPTOMETRY, INC.
COSTA MESA, CA 92627
COSTA MESA, CA 92627
33aNPI1548472921assigned 05/05/2007
33bProvider typeOptometrist
28Total paid$23K
24GClaims1,770
24DCodes billed5
24AFirst – last monthJan 2018 – Jul 2020
Compared with peers
Next to other Optometrist providers in California
Rank by total paid#939 of 1,899
Median peer was paid$23K
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 | 600 | $7K | |
| 2019 | 835 | $9K | |
| 2020 | 335 | $7K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 45% | 468 | 468 | $10K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 20% | 177 | 177 | $5K |
| 92015 | Determination of refractive state | 16% | 785 | 785 | $4K |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | 10% | 205 | 204 | $2K |
| V2020 | Frames, purchases | 8.5% | 135 | 135 | $2K |
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 officialBOURGOIN, MICHAEL (PRESIDENT)