Kelly's Fashion Optical

Kelly's Fashion Optical was paid $166K by Medicaid between Jan 2018 and Nov 2024, across 14 billing codes. Its largest line is V2100, Sphere, single vision, plano to plus or minus 4.00, per lens — 26% of everything it billed.

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	1,930	$13K
2019	2,558	$12K
2020	1,472	$5K
2021	2,740	$29K
2022	2,970	$49K
2023	2,299	$34K
2024incomplete	905	$22K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	26%	2,580	1,384	$43K
V2020	Frames, purchases	26%	4,295	4,194	$42K
92014	Ophthalmological services: medical examination and evaluation, comprehensive, established patient	14%	1,044	1,040	$23K
92012	Ophthalmological services: medical examination and evaluation, intermediate, established patient	12%	514	513	$20K
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	7.3%	1,356	722	$12K
92004	Ophthalmological services: medical examination and evaluation, comprehensive, new patient	6.5%	327	321	$11K
92002		4.8%	342	341	$8K
V2200	Sphere, bifocal, plano to plus or minus 4.00d, per lens	3.3%	277	136	$6K
S0621	Routine ophthalmological examination including refraction; established patient	<1%	43	43	$820.00
V2203	Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	<1%	69	41	$641.96
92340	Fitting of spectacles, except for aphakia; monofocal	<1%	15	14	$210.00
V2784	Lens, polycarbonate or equal, any index, per lens	<1%	1,846	915	$136.00

2 more codes

V2755	U-v lens, per lens	0%	2,138	$0.00
V2745	Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens	0%	28	$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 officialHERNANDEZ-RIVERA, CARMEN (OWNER)