1710654355

1710654355 was paid $350K by Medicaid between Oct 2021 and Sep 2024, across 14 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 88% of everything it billed.

33Billing provider info1710654355

33aNPI1710654355

33bProvider type—

28Total paid$350K

24GClaims13,452

24DCodes billed14

24AFirst – last monthOct 2021 – Sep 2024

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
2021	180	$7K
2022	2,007	$71K
2023	6,114	$150K
2024incomplete	5,151	$122K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
T1015	A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive	88%	2,513	2,428	$306K
92004	Ophthalmological services: medical examination and evaluation, comprehensive, new patient	5.7%	1,871	1,625	$20K
V2020	Frames, purchases	2.3%	1,773	1,558	$8K
92340	Fitting of spectacles, except for aphakia; monofocal	1.8%	1,291	1,113	$6K
92014	Ophthalmological services: medical examination and evaluation, comprehensive, established patient	1.0%	477	406	$4K
92015	Determination of refractive state	<1%	2,417	2,111	$3K
92341		<1%	397	356	$2K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	132	87	$359.45
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	0%	1,135	651	$0.00
V2104	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens	0%	106	71	$0.00
V2784	Lens, polycarbonate or equal, any index, per lens	0%	926	467	$0.00
V2744	Tint, photochromatic, per lens	0%	24	12	$0.00

2 more codes

V2203	Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	0%	298	$0.00
V2797	Vision supply, accessory and/or service component of another hcpcs vision code	0%	92	$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.