ANDREW PUDJOWARGONO, OD
2021 N RAINBOW BLVD STE 100, LAS VEGAS, NV 89108
NPI Number
1285120311
Practice location · View on Google Maps
Total Medicaid Payments
$9,736
-95% vs specialty average
Patients Seen
426
Total Claims
435
$ Per Patient
$23
Specialty avg: $38
Specialty Rank
#260 of 377
Optometrist providers in Nevada
Peer Average
$181,896
Average total for Optometrist
Claims per Patient
1.0
Average visits / services per person
Payments by Year
How much Medicaid paid this provider each year. Large jumps can indicate changes in practice volume or billing patterns.
| Year | Total Paid | % of Max |
|---|---|---|
| 2019 | $9,736 |
Procedure Code Breakdown
The specific medical services this provider billed Medicaid for. Each HCPCS/CPT code represents a different type of visit, test, or treatment.
| HCPCS Code | Description | Claims | Paid | % of Total | Avg per Claim |
|---|---|---|---|---|---|
| 92004 | Eye exam or vision test | 62 | $2,910 | 29.9% | $47 |
| 92014 | Eye exam or vision test | 58 | $2,655 | 27.3% | $46 |
| 92340 | Eye exam or vision test | 98 | $1,657 | 17.0% | $17 |
| V2020 | Frames, purchases | 96 | $1,475 | 15.1% | $15 |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 56 | $765 | 7.9% | $14 |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 14 | $198 | 2.0% | $14 |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 51 | $77 | 0.8% | $2 |
About This Data
This data comes from the HHS Medicaid Provider Spending dataset (opendata.hhs.gov). It shows payments made through Nevada Medicaid from 2018–2024. High payments do not mean a provider is doing anything wrong — some specialties naturally cost more, and busy providers see more patients. But unusually high numbers compared to peers can be worth a closer look.