Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

TIDEWATER EYE CENTER SPC

NPI: 1578638748 · PORTSMOUTH, VA 23703 · Ophthalmology Physician · NPI assigned 11/22/2006

$203K
Total Medicaid Paid
6,469
Total Claims
5,271
Beneficiaries
12
Codes Billed
2018-01
First Month
2021-07
Last Month

Provider Details

Authorized OfficialDEVANTIER, WAYNE (PRESIDENT)
NPI Enumeration Date11/22/2006

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 1,108 $23K
2019 2,058 $65K
2020 1,590 $61K
2021 1,713 $54K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient 1,961 1,538 $91K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 957 790 $24K
92134 1,360 1,087 $21K
67028 Intravitreal injection of a pharmacologic agent 537 432 $19K
92012 Ophthalmological services: medical examination and evaluation, intermediate, established patient 309 237 $10K
92250 323 276 $8K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient 129 124 $8K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 183 169 $7K
92083 226 198 $6K
J9035 Injection, bevacizumab, 10 mg 157 119 $5K
92015 Determination of refractive state 268 251 $2K
92133 59 50 $1K