1619054061

1619054061 was paid $112K by Medicaid between Jan 2018 and Aug 2020, across 4 billing codes. Its largest line is 92004, Ophthalmological services: medical examination and evaluation, comprehensive, new patient — 90% of everything it billed.

33Billing provider info1619054061

33aNPI1619054061

33bProvider type—

28Total paid$112K

24GClaims1,603

24DCodes billed4

24AFirst – last monthJan 2018 – Aug 2020

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	432	$39K
2019	759	$52K
2020	412	$22K

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	90%	1,140	1,130	$101K
92014	Ophthalmological services: medical examination and evaluation, comprehensive, established patient	5.3%	93	91	$6K
92015	Determination of refractive state	3.5%	263	259	$4K
3072F		<1%	107	105	$1K

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.