MID-DEL VISION SOURCE PLLC
NPI: 1578907598
· DEL CITY, OK 73115
· 332H00000X
$415K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
857 |
$31K |
| 2022 |
3,810 |
$131K |
| 2023 |
4,293 |
$161K |
| 2024 |
2,501 |
$93K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
1,546 |
1,546 |
$162K |
| 92004 |
|
827 |
827 |
$105K |
| 92340 |
|
1,757 |
1,752 |
$53K |
| 92015 |
|
2,473 |
2,473 |
$43K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,281 |
1,274 |
$32K |
| V2020 |
Vision svcs frames purchases |
1,808 |
1,802 |
$18K |
| V2100 |
Lens spher single plano 4.00 |
67 |
65 |
$1K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
14 |
14 |
$306.90 |
| V2784 |
Lens polycarb or equal |
1,688 |
1,681 |
$13.50 |