1861579633

1861579633 was paid $826K by Medicaid between Jan 2018 and Jun 2022, across 14 billing codes. Its largest line is 99204, doctor's office visit, new patient (more involved) — 25% of everything it billed.

33Billing provider info1861579633

33aNPI1861579633

33bProvider type—

28Total paid$826K

24GClaims25,724

24DCodes billed14

24AFirst – last monthJan 2018 – Jun 2022

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	4,389	$138K
2019	6,454	$181K
2020	7,130	$248K
2021	5,188	$174K
2022	2,563	$86K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
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	25%	3,397	2,904	$208K
92015	Determination of refractive state	15%	7,208	6,564	$122K
92014	Ophthalmological services: medical examination and evaluation, comprehensive, established patient	15%	2,944	2,598	$122K
92004	Ophthalmological services: medical examination and evaluation, comprehensive, new patient	14%	2,595	2,364	$117K
92285		12%	3,476	3,045	$101K
92340	Fitting of spectacles, except for aphakia; monofocal	10%	2,916	2,658	$83K
92083		6.4%	1,518	1,324	$53K
92250		2.0%	500	423	$17K
92060		<1%	132	132	$3K
92012	Ophthalmological services: medical examination and evaluation, intermediate, established patient	<1%	13	13	$585.00
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	0%	182	182	$0.00
V2784	Lens, polycarbonate or equal, any index, per lens	0%	313	313	$0.00

2 more codes

V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	0%	108	$0.00
V2020	Frames, purchases	0%	422	$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.