1619173895

1619173895 was paid $13K by Medicaid between Jan 2020 and Jun 2021, across 9 billing codes. Its largest line is 92014, Ophthalmological services: medical examination and evaluation, comprehensive, established patient — 38% of everything it billed.

33Billing provider info1619173895

33aNPI1619173895

33bProvider type—

28Total paid$13K

24GClaims411

24DCodes billed9

24AFirst – last monthJan 2020 – Jun 2021

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
2020	285	$8K
2021	126	$5K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
92014	Ophthalmological services: medical examination and evaluation, comprehensive, established patient	38%	55	55	$5K
V2020	Frames, purchases	35%	109	109	$5K
92100		23%	84	84	$3K
92015	Determination of refractive state	2.3%	16	16	$304.32
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	1.8%	24	24	$242.00
92283		0%	85	84	$0.00
2024F		0%	13	13	$0.00
2025F		0%	12	12	$0.00
92083		0%	13	13	$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.