EYECARE OF GRAND LAKE PLLC
NPI: 1932774189
· GROVE, OK 74344
· 152W00000X
$106K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
899 |
$38K |
| 2023 |
1,203 |
$40K |
| 2024 |
961 |
$27K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
|
311 |
311 |
$40K |
| 92340 |
|
521 |
520 |
$16K |
| 92014 |
|
110 |
110 |
$12K |
| 92015 |
|
670 |
669 |
$12K |
| 99203 |
|
130 |
130 |
$11K |
| V2020 |
Vision svcs frames purchases |
552 |
549 |
$6K |
| V2100 |
Lens spher single plano 4.00 |
129 |
129 |
$3K |
| 99213 |
|
45 |
41 |
$3K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
99 |
99 |
$2K |
| V2784 |
Lens polycarb or equal |
496 |
493 |
$0.00 |