HAZELWOOD UGARTE, JENNIFER
NPI: 1801936638
· FAIRLAWN, OH 44333
· 152W00000X
$254K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
3,104 |
$59K |
| 2019 |
827 |
$18K |
| 2020 |
1,033 |
$18K |
| 2021 |
3,364 |
$53K |
| 2022 |
2,298 |
$34K |
| 2023 |
2,108 |
$29K |
| 2024 |
2,214 |
$42K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
1,771 |
1,734 |
$67K |
| 92340 |
|
1,788 |
1,747 |
$32K |
| V2020 |
Vision svcs frames purchases |
2,551 |
2,448 |
$30K |
| V2100 |
Lens spher single plano 4.00 |
1,693 |
1,608 |
$29K |
| 92015 |
|
2,538 |
2,491 |
$24K |
| 92004 |
|
540 |
536 |
$20K |
| V2750 |
Anti-reflective coating |
967 |
943 |
$20K |
| V2760 |
Scratch resistant coating |
1,095 |
1,071 |
$11K |
| V2755 |
Uv lens/es |
1,130 |
1,103 |
$7K |
| V2784 |
Lens polycarb or equal |
540 |
503 |
$5K |
| V2782 |
Lens, 1.54-1.65 p/1.60-1.79g |
69 |
69 |
$4K |
| 92341 |
|
155 |
155 |
$3K |
| V2200 |
Lens spher bifoc plano 4.00d |
57 |
57 |
$885.40 |
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
13 |
13 |
$832.00 |
| 92310 |
|
16 |
14 |
$507.00 |
| V2744 |
Tint photochromatic lens/es |
13 |
13 |
$480.00 |
| V2781 |
Progressive lens per lens |
12 |
12 |
$448.00 |