1164435780

$3.51M

Total Medicaid Paid

115,568

Total Claims

104,274

Beneficiaries

54

Codes Billed

2018-01

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99214		8,560	8,325	$493K
99213		8,286	7,998	$374K
99204		3,682	3,591	$308K
92083		9,450	9,217	$306K
92014		2,951	2,876	$184K
92012		3,646	3,504	$162K
92004		2,583	2,530	$158K
92134		10,104	9,799	$155K
92202		15,673	15,348	$141K
67028		1,899	1,650	$121K
99203		1,369	1,364	$106K
92226		7,644	4,244	$101K
68761		2,126	1,137	$91K
66984		509	470	$87K
92133		3,980	3,909	$78K
92225		4,166	2,323	$75K
99212		2,216	2,145	$72K
92020		5,703	5,524	$67K
93886		1,428	1,347	$50K
93892		1,419	1,346	$45K
93890		1,420	1,347	$41K
J9035	Bevacizumab injection	1,333	1,152	$40K
92250		1,200	1,167	$30K
92002		505	504	$30K
92060		520	510	$24K
92286		1,191	1,143	$24K
92285		1,464	1,415	$21K
92136		1,148	1,047	$21K
92273		356	331	$13K
V2020	Vision svcs frames purchases	1,674	1,641	$10K
92201		633	593	$8K
J0178	Aflibercept injection	14	12	$7K
99215	Prolong outpt/office vis	139	129	$7K
66982		41	37	$7K
V2103	Spherocylindr 4.00d/12-2.00d	897	456	$6K
92235		161	154	$6K
76512		246	175	$6K
76514		1,119	1,086	$6K
V2100	Lens spher single plano 4.00	754	463	$5K
S0620	Routine ophthalmological exa	254	254	$5K
66761		40	31	$4K
V2203	Lens sphcyl bifocal 4.00d/.1	262	136	$3K
V2784	Lens polycarb or equal	1,156	597	$2K
S0621	Routine ophthalmological exa	66	66	$2K
92145		183	183	$2K
92015		400	399	$946.42
99441		30	30	$796.33
92025		25	24	$503.86
83861		95	57	$330.46
V2200	Lens spher bifoc plano 4.00d	20	12	$190.32
V2104	Spherocylindr 4.00d/2.12-4d	35	18	$90.41
99072		332	326	$35.00
99080		406	79	$0.00
A4262	Temporary tear duct plug	55	53	$0.00

Medicaid Provider Spending