1639294101

1639294101 was paid $164K by Medicaid between Feb 2020 and Dec 2022, across 9 billing codes. Its largest line is 92004, Ophthalmological services: medical examination and evaluation, comprehensive, new patient — 48% of everything it billed.

33Billing provider info1639294101

33aNPI1639294101

33bProvider type—

28Total paid$164K

24GClaims5,320

24DCodes billed9

24AFirst – last monthFeb 2020 – Dec 2022

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	1,489	$46K
2021	2,109	$65K
2022	1,722	$53K

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	48%	1,742	1,630	$78K
92340	Fitting of spectacles, except for aphakia; monofocal	20%	1,093	1,026	$32K
92015	Determination of refractive state	19%	1,729	1,611	$31K
92341		5.9%	338	314	$10K
V2025	Deluxe frame	4.3%	218	191	$7K
92012	Ophthalmological services: medical examination and evaluation, intermediate, established patient	2.6%	94	84	$4K
V2020	Frames, purchases	<1%	45	45	$1K
V2105	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens	<1%	49	46	$339.50
V2208	Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens	<1%	12	12	$108.00

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.