Pelfrey-Jones, Sandra
Pelfrey-Jones, Sandra was paid $927K by Medicaid between Jan 2018 and Dec 2024, across 12 billing codes. Its largest line is 92014, Ophthalmological services: medical examination and evaluation, comprehensive, established patient — 29% of everything it billed.
33Billing provider infoPELFREY-JONES, SANDRA
LINCOLN, IL 62656
LINCOLN, IL 62656
33aNPI1770589244assigned 06/21/2005
33bProvider typeOptometrist
28Total paid$927K
24GClaims34,532
24DCodes billed12
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Optometrist providers in Illinois
Rank by total paid#61 of 1,069
Median peer was paid$56K
This provider vs. median17×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
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 | 2,891 | $77K | |
| 2019 | 4,642 | $138K | |
| 2020 | 4,287 | $131K | |
| 2021 | 6,923 | $184K | |
| 2022 | 5,160 | $129K | |
| 2023 | 5,352 | $129K | |
| 2024incomplete | 5,277 | $138K |
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 | 29% | 6,442 | 5,940 | $267K |
| 92015 | Determination of refractive state | 17% | 9,197 | 8,421 | $158K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 13% | 2,738 | 2,470 | $122K |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | 10% | 3,284 | 2,898 | $93K |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 9.6% | 3,483 | 3,103 | $89K |
| V2025 | Deluxe frame | 6.4% | 1,184 | 1,101 | $59K |
| V2020 | Frames, purchases | 4.6% | 3,449 | 3,075 | $42K |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | 4.2% | 868 | 833 | $39K |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 2.9% | 2,823 | 2,424 | $27K |
| V2200 | Sphere, bifocal, plano to plus or minus 4.00d, per lens | 1.8% | 386 | 335 | $16K |
| 92341 | 1.0% | 333 | 292 | $9K | |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | <1% | 345 | 335 | $4K |
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.