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NPI 1689630600
NPI deactivated
1689630600
1689630600 was paid $29K by Medicaid between Jan 2018 and Oct 2019, across 13 billing codes. Its largest line is 92014, Ophthalmological services: medical examination and evaluation, comprehensive, established patient — 33% of everything it billed.
33Billing provider info1689630600
33aNPI1689630600
33bProvider type—
28Total paid$29K
24GClaims4,963
24DCodes billed13
24AFirst – last monthJan 2018 – Oct 2019
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 | 4,116 | $17K | |
| 2019 | 847 | $12K |
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 | 33% | 638 | 638 | $10K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 25% | 543 | 543 | $7K |
| V2020 | Frames, purchases | 21% | 1,182 | 1,180 | $6K |
| 92015 | Determination of refractive state | 5.5% | 523 | 523 | $2K |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 4.7% | 496 | 327 | $1K |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 4.4% | 436 | 288 | $1K |
| V2200 | Sphere, bifocal, plano to plus or minus 4.00d, per lens | 2.6% | 314 | 203 | $754.00 |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 2.0% | 306 | 195 | $588.00 |
| V2203 | Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 1.9% | 225 | 138 | $546.00 |
| V2599 | Contact lens, other type | 0% | 139 | 139 | $0.00 |
| S0620 | Routine ophthalmological examination including refraction; new patient | 0% | 43 | 43 | $0.00 |
| V2745 | Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens | 0% | 23 | 12 | $0.00 |
1 more codes
| S0621 | Routine ophthalmological examination including refraction; established patient | 0% | 95 | $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.