Pediatric Ophthalmology Associates INC.

Pediatric Ophthalmology Associates INC. was paid $9.60M by Medicaid between Jan 2018 and Dec 2024, across 21 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 25% of everything it billed.

33Billing provider infoPEDIATRIC OPHTHALMOLOGY ASSOCIATES INC.
COLUMBUS, OH 43205

33aNPI1831257161assigned 12/06/2006

33bProvider typeOphthalmology Physician

28Total paid$9.60M

24GClaims274,911

24DCodes billed21

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Ophthalmology Physician providers in Ohio

Rank by total paid#2 of 155

Median peer was paid$10K

This provider vs. median923×

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	42,039	$1.53M
2019	40,425	$1.46M
2020	29,466	$1.06M
2021	35,996	$1.25M
2022	40,182	$1.39M
2023	43,831	$1.44M
2024incomplete	42,972	$1.47M

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
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	25%	38,782	37,206	$2.37M
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	20%	23,371	22,509	$1.96M
92060		17%	83,221	79,818	$1.61M
92015	Determination of refractive state	15%	76,168	73,274	$1.48M
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	12%	27,211	26,116	$1.14M
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	5.6%	9,574	9,099	$537K
99233	Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m	2.5%	6,085	4,258	$242K
92201		<1%	4,832	3,276	$84K
67311		<1%	97	94	$51K
92340	Fitting of spectacles, except for aphakia; monofocal	<1%	1,822	1,811	$32K
99254		<1%	461	444	$31K
92226		<1%	2,465	1,017	$29K

9 more codes

99222	Initial hospital care, per day, moderate complexity	<1%	136	$7K
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	<1%	154	$5K
V2020	Frames, purchases	<1%	188	$4K
92004	Ophthalmological services: medical examination and evaluation, comprehensive, new patient	<1%	64	$3K
V2784	Lens, polycarbonate or equal, any index, per lens	<1%	187	$2K
99223	Prolong inpt eval add15 m	<1%	27	$2K
V2523	Contact lens, hydrophilic, extended wear, per lens	<1%	26	$1K
92014	Ophthalmological services: medical examination and evaluation, comprehensive, established patient	<1%	27	$1K
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	<1%	13	$416.00

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.

From NPPES

Who's on the registration

Authorized officialEDWARDS, PHYNESIA (PRACTICE ADMINISTRATOR)