Gould, Nelson

Gould, Nelson was paid $460K by Medicaid between Jan 2018 and Nov 2022, across 12 billing codes. Its largest line is 92015, Determination of refractive state — 23% of everything it billed.

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	2,549	$87K
2019	2,603	$89K
2020	2,200	$76K
2021	3,289	$117K
2022	2,646	$92K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
92015	Determination of refractive state	23%	2,859	2,730	$104K
92014	Ophthalmological services: medical examination and evaluation, comprehensive, established patient	19%	1,859	1,789	$88K
92250		16%	1,920	1,835	$73K
V2020	Frames, purchases	12%	1,907	1,842	$54K
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	9.2%	1,429	1,375	$42K
92340	Fitting of spectacles, except for aphakia; monofocal	8.0%	1,757	1,699	$37K
92004	Ophthalmological services: medical examination and evaluation, comprehensive, new patient	7.2%	521	498	$33K
S0580	Polycarbonate lens (list this code in addition to the basic code for the lens)	5.6%	925	890	$26K
99214	Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	<1%	28	26	$1K
99204	Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	<1%	14	14	$1K
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	<1%	52	51	$1K
92341		<1%	16	14	$318.63

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.