1699000604

1699000604 was paid $60K by Medicaid between Jan 2018 and Jul 2019, across 8 billing codes. Its largest line is V2100, Sphere, single vision, plano to plus or minus 4.00, per lens — 46% of everything it billed.

33Billing provider info1699000604

33aNPI1699000604

33bProvider type—

28Total paid$60K

24GClaims1,374

24DCodes billed8

24AFirst – last monthJan 2018 – Jul 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	858	$37K
2019	516	$23K

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	46%	411	405	$27K
V2020	Frames, purchases	39%	441	433	$24K
92340	Fitting of spectacles, except for aphakia; monofocal	7.5%	316	314	$4K
92004	Ophthalmological services: medical examination and evaluation, comprehensive, new patient	3.4%	29	29	$2K
S0580	Polycarbonate lens (list this code in addition to the basic code for the lens)	2.1%	67	66	$1K
92341		1.5%	45	45	$900.00
92371		<1%	45	45	$301.00
92015	Determination of refractive state	0%	20	20	$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.