CUSTOM EYES, LLC SOS Verified
175 N STEPHANIE ST SUITE 130, HENDERSON, NV 89074
NPI Number
1386820421
Practice location · View on Google Maps
SOS Verification: Verified
Entity Name: CUSTOM EYES LLC
Entity Number: E0691232007-3
Entity Type: Domestic Limited-Liability Company
Entity Status: Active
Formation Date: 2007-09-26
Status Changed: 2010-10-19
Name Match: 95%
Registered Agent
Name: CHRISTINA C. WOLOSIN
Type: Non-Commercial Registered Agent
Address: 175 NORTH STEPHANIE, STE. 130, HENDERSON, NV, 89074
Officers / Principals
| Title | Name | Address | Status |
|---|---|---|---|
| Manager | DAVID WOLOSIN | P.O. BOX 230747, LAS VEGAS, NV, 89105 | Active |
Total Medicaid Payments
$202,049
-4% vs specialty average
Patients Seen
5,416
Total Claims
5,722
$ Per Patient
$37
Specialty avg: $21
Specialty Rank
#3 of 24
Eyewear Supplier (Equipment, not the service) providers in Nevada
Peer Average
$211,460
Average total for Eyewear Supplier (Equipment, not the service)
Claims per Patient
1.1
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 |
|---|---|---|
| 2018 | $6,455 | |
| 2019 | $2,808 | |
| 2020 | $29,372 | |
| 2021 | $45,031 | |
| 2022 | $32,875 | |
| 2023 | $36,774 | |
| 2024 | $48,734 |
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 |
|---|---|---|---|---|---|
| V2020 | Frames, purchases | 2,672 | $113,238 | 56.0% | $42 |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 1,933 | $63,286 | 31.3% | $33 |
| 92340 | Eye exam or vision test | 717 | $16,131 | 8.0% | $22 |
| V2104 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens | 105 | $4,084 | 2.0% | $39 |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 75 | $2,440 | 1.2% | $33 |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 45 | $1,461 | 0.7% | $32 |
| V2760 | Scratch resistant coating, per lens | 88 | $526 | 0.3% | $6 |
| V2025 | Deluxe frame | 71 | $520 | 0.3% | $7 |
| 92341 | Eye exam or vision test | 16 | $363 | 0.2% | $23 |
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.