MICHAEL L SUSSEX OD PC

$292K

Total Medicaid Paid

12,587

Total Claims

12,322

Beneficiaries

22

Codes Billed

2018-01

First Month

2019-02

Last Month

Year	Claims	Total Paid
2018	12,343	$287K
2019	244	$5K

Code	Description	Claims	Beneficiaries	Total Paid
V2020	Frames, purchases	2,153	2,093	$66K
S0621	Routine ophthalmological examination including refraction; established patient	930	916	$45K
S0620	Routine ophthalmological examination including refraction; new patient	803	791	$36K
92340		1,814	1,767	$35K
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	1,182	1,156	$25K
92014		281	275	$16K
92341		518	509	$12K
92004		116	113	$9K
99214		175	174	$8K
V2784	Lens, polycarbonate or equal, any index, per lens	1,711	1,673	$8K
92015		685	674	$7K
V2203	Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	309	302	$7K
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	423	409	$7K
V2104	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens	139	134	$3K
99213		72	70	$3K
99204		14	14	$1K
92250		51	50	$1K
V2200	Sphere, bifocal, plano to plus or minus 4.00d, per lens	66	66	$988.89
V2107	Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens	29	29	$337.30
V2715	Prism, per lens	59	58	$302.20
V2756	Eye glass case	396	392	$88.56
1036F		661	657	$0.00

Medicaid Provider Spending