Medicaid Provider Spending

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

OPTUM MEDICAL CARE OF NEW JERSEY PC

NPI: 1578665048 · SECAUCUS, NJ 07094 · Durable Medical Equipment & Medical Supplies · NPI assigned 09/03/2006

$218.82M
Total Medicaid Paid
4,314,959
Total Claims
3,884,408
Beneficiaries
448
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialBRAHMBHATT, GAURANG (CMO)
NPI Enumeration Date09/03/2006

Related Entities

Other providers sharing the same authorized official: BRAHMBHATT, GAURANG

ProviderCityStateTotal Paid
A.G. DIKENGIL, MD, PA LYNDHURST NJ $1.03M
RIVERSIDE PEDIATRIC GROUP, PC UNION CITY NJ $40K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 444,913 $22.16M
2019 526,234 $22.66M
2020 587,564 $30.43M
2021 642,507 $39.37M
2022 854,032 $42.78M
2023 734,968 $37.02M
2024 524,741 $24.39M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 809,661 744,476 $65.18M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 919,464 836,730 $54.13M
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 47,667 45,935 $6.11M
90460 Immunization administration through 18 years of age via any route, first or only component 216,337 209,491 $5.77M
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 51,110 50,429 $4.95M
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 110,385 104,828 $4.74M
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 46,099 45,400 $4.46M
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 25,657 24,366 $4.06M
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 43,330 41,837 $3.74M
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 34,757 34,234 $3.65M
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 31,753 30,844 $2.80M
L3000 Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each 12,470 5,908 $2.60M
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 24,340 23,689 $2.48M
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 22,536 22,036 $2.41M
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 224,152 215,000 $2.40M
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 64,999 61,461 $2.38M
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 8,517 8,171 $2.37M
95810 Polysomnography; sleep staging with 4 or more additional parameters 3,845 3,778 $2.15M
99244 Office or other outpatient consultation, moderate to high complexity 12,848 12,713 $2.12M
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 6,699 6,208 $2.04M
92552 59,990 59,185 $1.73M
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 123,096 77,176 $1.65M
90792 Psychiatric diagnostic evaluation with medical services 6,391 5,783 $1.63M
45380 Colonoscopy, flexible; with biopsy, single or multiple 5,060 4,661 $1.46M
93970 8,805 8,472 $1.30M
90461 55,435 53,882 $1.23M
99232 Subsequent hospital care, per day, moderate complexity 35,827 13,364 $1.04M
90832 Psychotherapy, 30 minutes with patient 16,121 11,650 $953K
99243 8,239 8,231 $905K
99215 Prolong outpt/office vis 9,268 8,677 $872K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 62,582 59,883 $840K
93000 69,847 67,045 $837K
90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) 16,920 15,250 $830K
36465 705 441 $799K
96110 Developmental screening, with scoring and documentation, per standardized instrument 88,666 76,545 $772K
93229 1,517 1,303 $747K
27447 989 893 $629K
93015 9,322 8,999 $623K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 1,739 1,475 $596K
95004 Percutaneous tests with allergenic extracts, immediate type reaction 5,616 5,352 $588K
20610 10,870 8,402 $554K
95806 3,761 3,663 $516K
73620 25,083 14,997 $496K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 25,943 22,477 $484K
92588 18,558 18,297 $467K
36475 294 229 $430K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 21,907 7,366 $426K
93880 3,009 2,817 $420K
93925 2,683 2,556 $419K
95782 438 392 $418K
95165 Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials 1,349 747 $418K
31231 2,254 2,141 $418K
95811 797 768 $390K
29540 17,762 10,489 $378K
96127 72,642 70,326 $330K
90686 42,095 39,364 $306K
98941 Chiropractic manipulative treatment; spinal, 3-4 regions 9,944 3,966 $302K
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose 4,635 4,074 $271K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient 9,840 9,081 $265K
J7323 Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose 2,302 1,276 $247K
90834 Psychotherapy, 45 minutes with patient 2,769 2,377 $226K
90674 15,321 14,466 $223K
90746 4,361 4,152 $217K
92250 5,713 5,210 $213K
94060 4,578 4,331 $212K
94729 4,853 4,607 $209K
99222 Initial hospital care, per day, moderate complexity 3,873 3,435 $206K
99188 12,370 11,997 $202K
73564 4,937 4,042 $195K
92551 25,778 25,347 $189K
17110 2,360 1,959 $189K
93971 1,821 1,466 $187K
90791 Psychiatric diagnostic evaluation 1,354 1,311 $184K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 761 732 $180K
90651 5,933 5,022 $180K
31575 1,880 1,813 $174K
99238 Hospital discharge day management, 30 minutes or less 3,687 3,558 $173K
99239 Hospital discharge day management, more than 30 minutes 3,719 3,211 $172K
95930 1,728 1,727 $171K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 12,236 4,104 $162K
95117 16,871 10,091 $162K
94727 4,855 4,614 $160K
97161 3,606 3,518 $150K
99205 Prolong outpt/office vis 918 889 $150K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 2,380 2,357 $138K
99385 1,223 1,199 $137K
93268 625 625 $135K
99460 1,871 1,833 $133K
99174 15,408 15,066 $127K
69210 3,917 3,359 $126K
99233 Prolong inpt eval add15 m 2,999 1,462 $113K
36466 78 64 $113K
11900 2,877 2,577 $111K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient 9,417 8,083 $110K
92567 8,550 8,091 $105K
99223 Prolong inpt eval add15 m 1,515 1,401 $104K
90670 9,386 8,568 $104K
11901 2,037 1,861 $98K
90715 4,012 3,666 $97K
93923 1,552 1,522 $96K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 5,328 4,936 $87K
92557 3,687 3,559 $87K
20611 1,307 957 $85K
73630 3,555 2,689 $80K
99245 418 418 $79K
94010 2,970 2,879 $78K
99386 599 589 $78K
90750 616 570 $72K
99231 Subsequent hospital care, per day, straightforward or low complexity 3,245 1,043 $70K
0012A 2,491 2,490 $69K
64483 430 426 $69K
73562 2,150 1,856 $66K
99309 Subsequent nursing facility care, per day, low to moderate complexity 3,661 2,541 $63K
73030 2,111 1,823 $63K
90619 2,311 2,189 $61K
92225 1,394 1,363 $61K
83655 6,091 5,920 $58K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 15,936 12,789 $57K
92012 Ophthalmological services: medical examination and evaluation, intermediate, established patient 1,756 1,490 $57K
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) 15,585 14,002 $54K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination 2,624 1,251 $53K
99173 50,914 45,509 $51K
92550 4,102 3,932 $51K
97530 Therapeutic activities, direct patient contact, each 15 minutes 1,987 1,232 $48K
0011A 2,704 2,696 $48K
0071A 1,194 1,184 $46K
10060 505 443 $44K
98940 1,850 794 $41K
92136 912 805 $40K
99308 Subsequent nursing facility care, per day, straightforward 2,308 1,826 $39K
94618 1,434 1,340 $38K
95012 2,199 2,099 $37K
11301 355 330 $37K
10061 257 236 $36K
99442 1,113 1,044 $36K
11306 247 215 $35K
92579 966 951 $35K
96401 543 429 $34K
G0444 Annual depression screening, 5 to 15 minutes 3,126 2,930 $34K
90621 1,347 1,305 $34K
72100 1,165 1,093 $33K
99443 973 735 $33K
0072A 828 827 $33K
73600 1,481 1,096 $32K
99441 1,755 1,553 $31K
72114 445 441 $31K
99397 749 677 $31K
97164 1,093 1,042 $28K
36416 6,201 5,263 $28K
90734 1,606 1,583 $28K
99462 861 666 $28K
90682 627 627 $28K
90472 Immunization administration, each additional vaccine (list separately) 2,222 2,155 $28K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 239 201 $27K
94664 2,573 2,425 $27K
92587 1,572 1,514 $27K
90677 2,557 2,486 $27K
93228 1,476 1,274 $25K
73610 1,011 805 $25K
93458 114 111 $25K
86580 3,709 3,682 $25K
72110 475 475 $24K
29515 426 228 $24K
G0447 Face-to-face behavioral counseling for obesity, 15 minutes 1,307 1,266 $24K
93298 1,430 1,366 $23K
73521 622 581 $22K
76857 770 732 $22K
94375 648 615 $21K
93922 289 251 $21K
11721 2,188 2,085 $21K
96112 232 214 $20K
99401 1,916 1,878 $20K
0064A 636 614 $20K
99220 254 254 $19K
62323 167 160 $19K
A9502 Technetium tc-99m tetrofosmin, diagnostic, per study dose 383 337 $18K
G2066 Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results 1,653 1,474 $17K
90698 5,309 4,913 $17K
J0696 Injection, ceftriaxone sodium, per 250 mg 4,641 3,660 $16K
76775 361 345 $16K
93296 1,499 1,374 $16K
J1439 Injection, ferric carboxymaltose, 1 mg 22 12 $15K
72275 535 527 $15K
66761 80 49 $15K
92134 657 593 $15K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 455 155 $14K
92558 1,777 1,719 $14K
96101 263 249 $14K
64493 138 130 $14K
L4360 Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise 83 74 $13K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia 72 72 $13K
99348 685 585 $13K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 188 78 $12K
73560 454 424 $12K
11750 85 81 $12K
90662 1,988 1,873 $12K
98942 260 98 $12K
92340 Fitting of spectacles, except for aphakia; monofocal 721 586 $12K
85018 5,768 5,572 $11K
93297 788 728 $11K
0001A 395 392 $10K
90633 4,406 3,923 $10K
0002A 283 283 $10K
11102 131 124 $9K
J2785 Injection, regadenoson, 0.1 mg 383 352 $9K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 3,087 2,731 $9K
20605 266 247 $9K
93294 823 755 $9K
92025 348 326 $8K
90836 143 133 $8K
J0153 Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds) 3,197 2,714 $8K
57454 62 61 $8K
95115 930 562 $8K
90756 469 449 $8K
90661 3,330 3,305 $7K
93295 323 292 $7K
90620 150 147 $7K
90680 3,468 3,239 $7K
0013A 249 241 $7K
90710 406 341 $7K
L3260 Surgical boot/shoe, each 302 283 $7K
81025 1,295 1,044 $7K
73502 167 161 $7K
72050 122 122 $6K
64494 136 128 $6K
95805 14 14 $6K
95018 54 52 $6K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 513 482 $6K
92083 141 125 $6K
92015 Determination of refractive state 5,420 4,622 $6K
99381 70 67 $6K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 998 911 $6K
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 1,474 1,261 $6K
J2920 Injection, methylprednisolone sodium succinate, up to 40 mg 1,038 915 $6K
57456 54 52 $6K
92202 485 448 $5K
64484 104 101 $5K
J1885 Injection, ketorolac tromethamine, per 15 mg 2,778 2,477 $5K
72040 142 138 $5K
92020 258 246 $5K
20985 134 89 $5K
99307 350 281 $5K
J1030 Injection, methylprednisolone acetate, 40 mg 1,115 947 $5K
20550 112 83 $5K
64495 90 86 $5K
J7324 Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose 61 34 $5K
11730 59 55 $4K
90716 652 555 $4K
97014 350 140 $4K
11311 46 43 $4K
99349 172 158 $4K
90707 722 617 $4K
66984 Extracapsular cataract removal with insertion of intraocular lens prosthesis 27 14 $4K
72052 71 71 $4K
77002 82 70 $4K
99336 543 385 $4K
68761 26 25 $4K
82962 6,878 5,745 $4K
J1010 Injection, methylprednisolone acetate, 1 mg 341 305 $4K
95250 57 56 $4K
73110 79 73 $4K
81002 2,942 2,857 $3K
97802 468 450 $3K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 684 680 $3K
90736 20 20 $3K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 273 240 $3K
99337 121 109 $3K
87070 526 488 $3K
99152 108 97 $3K
94760 3,256 2,986 $3K
73140 66 57 $3K
99241 56 56 $3K
93280 142 129 $3K
81003 10,223 9,709 $3K
92226 160 157 $3K
90732 30 30 $3K
90636 26 26 $2K
51798 149 148 $2K
90473 190 190 $2K
87634 209 200 $2K
99217 81 81 $2K
99242 28 28 $2K
90696 426 354 $2K
95251 106 95 $2K
92553 59 54 $2K
92286 126 107 $2K
90744 2,140 1,949 $2K
90700 976 873 $2K
87081 479 474 $2K
76512 51 42 $2K
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 1,250 912 $2K
36415 Collection of venous blood by venipuncture 1,033 991 $2K
80061 Lipid panel 203 203 $2K
97162 27 27 $2K
33016 16 14 $2K
60100 12 12 $2K
0134A 67 64 $1K
00813 13 12 $1K
69209 113 100 $1K
92133 44 44 $1K
99253 15 13 $1K
29580 25 14 $1K
10040 19 15 $1K
76514 107 107 $1K
90713 479 421 $1K
91322 20 17 $1K
36470 16 12 $1K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 33 33 $1K
93224 15 15 $1K
90653 139 135 $1K
J1040 Injection, methylprednisolone acetate, 80 mg 106 105 $995.17
90694 137 131 $893.48
00811 16 15 $883.50
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg 169 142 $858.12
51741 92 91 $836.03
92201 44 44 $827.97
90632 13 13 $817.65
99383 12 12 $815.69
99051 1,590 1,546 $813.73
G0008 Administration of influenza virus vaccine 1,295 1,238 $810.91
91320 13 13 $807.75
36410 48 48 $791.02
87400 254 119 $760.12
90672 211 211 $758.42
73130 22 15 $733.88
87811 Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) 23 19 $662.08
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 13 13 $658.38
90480 33 31 $657.80
94770 334 332 $656.66
96161 250 230 $655.52
90697 297 294 $605.40
99406 69 54 $600.51
99497 45 35 $578.40
T1013 Sign language or oral interpretive services, per 15 minutes 88 84 $555.00
11056 61 57 $544.19
90649 120 75 $530.57
91301 4,610 4,529 $528.00
90688 144 109 $519.32
97803 211 202 $509.82
J1020 Injection, methylprednisolone acetate, 20 mg 241 239 $504.65
97022 176 69 $498.26
73080 13 13 $495.59
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg 1,057 840 $482.12
99335 104 71 $478.38
94070 14 13 $473.68
S0020 Injection, bupivicaine hydrochloride, 30 ml 68 65 $471.86
G0283 Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care 1,625 515 $466.09
93016 28 24 $399.56
99459 22 21 $391.45
3074F 19,193 17,810 $382.00
3078F 17,642 16,362 $375.00
90648 523 470 $357.64
S0119 Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) 116 116 $343.24
97035 170 58 $321.44
97032 115 42 $278.39
J1100 Injection, dexamethasone sodium phosphate, 1 mg 419 380 $271.77
99225 14 12 $268.78
96160 93 93 $234.64
90656 1,160 1,149 $234.37
93018 28 24 $226.23
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 140 123 $214.11
99024 3,802 3,192 $213.00
90658 47 45 $186.40
92132 12 12 $178.00
11720 27 26 $177.91
99347 13 13 $163.45
90685 206 203 $154.70
3079F 6,095 5,728 $151.00
90474 12 12 $148.18
85610 57 38 $143.03
87807 39 39 $119.88
76937 16 12 $110.11
99050 15 14 $84.85
3075F 2,094 2,007 $75.00
J7510 Prednisolone oral, per 5 mg 29 28 $73.78
G0101 Cervical or vaginal cancer screening; pelvic and clinical breast examination 12 12 $72.34
82947 31 30 $64.55
96380 48 48 $61.28
V2020 Frames, purchases 6,286 6,118 $60.00
3077F 2,311 2,174 $57.00
99072 3,009 2,681 $44.00
V2100 Sphere, single vision, plano to plus or minus 4.00, per lens 6,024 3,114 $42.00
97760 30 28 $41.91
G9016 Smoking cessation counseling, individual, in the absence of or in addition to any other evaluation and management service, per session (6-10 minutes) [demo project code only] 14 13 $36.00
1126F 425 399 $31.00
91307 90 86 $30.00
3045F 136 110 $27.00
3061F 252 227 $24.00
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 4,175 3,034 $21.00
3044F 3,815 3,179 $20.00
J2919 Injection, methylprednisolone sodium succinate, 5 mg 20 13 $16.76
G8510 Screening for depression is documented as negative, a follow-up plan is not required 25,261 24,072 $15.20
J7512 Prednisone, immediate release or delayed release, oral, 1 mg 12 12 $11.00
1125F 257 240 $10.00
3080F 696 669 $9.00
3008F 12,959 12,451 $7.00
J2357 Injection, omalizumab, 5 mg 31 24 $6.00
91300 103 103 $5.00
91313 61 56 $5.00
91306 27 27 $2.00
2024F 14 14 $1.00
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 6,882 6,148 $0.00
G8752 Most recent systolic blood pressure < 140 mmhg 14,319 12,507 $0.00
0502F 698 433 $0.00
4004F 292 264 $0.00
1124F 4,775 4,620 $0.00
G8482 Influenza immunization administered or previously received 2,769 2,730 $0.00
G8431 Screening for depression is documented as being positive and a follow-up plan is documented 1,229 1,140 $0.00
G8483 Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) 2,516 2,407 $0.00
G8753 Most recent systolic blood pressure >= 140 mmhg 1,133 1,040 $0.00
1160F 43 39 $0.00
1033F 156 154 $0.00
94799 64 64 $0.00
V2203 Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 616 318 $0.00
1159F 267 252 $0.00
2022F 324 260 $0.00
V2750 Anti-reflective coating, per lens 2,695 1,367 $0.00
2028F 27 27 $0.00
4040F 17 16 $0.00
90655 29 29 $0.00
J0897 Injection, denosumab, 1 mg 44 29 $0.00
3288F 45 27 $0.00
90630 12 12 $0.00
G8420 Bmi is documented within normal parameters and no follow-up plan is required 1,858 1,718 $0.00
G8754 Most recent diastolic blood pressure < 90 mmhg 19,696 17,047 $0.00
99000 812 763 $0.00
1036F 10,294 9,612 $0.00
G0009 Administration of pneumococcal vaccine 26 26 $0.00
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 2,610 1,341 $0.00
G9903 Patient screened for tobacco use and identified as a tobacco non-user 389 288 $0.00
J3590 Unclassified biologics 347 239 $0.00
G8418 Bmi is documented below normal parameters and a follow-up plan is documented 256 251 $0.00
V2784 Lens, polycarbonate or equal, any index, per lens 5,102 2,614 $0.00
G8419 Bmi documented outside normal parameters, no follow-up plan documented, no reason given 503 464 $0.00
92310 12 12 $0.00
V2781 Progressive lens, per lens 135 65 $0.00
1111F 39 38 $0.00
1101F 90 90 $0.00
V2200 Sphere, bifocal, plano to plus or minus 4.00d, per lens 199 98 $0.00
V2299 Specialty bifocal (by report) 110 53 $0.00
S0620 Routine ophthalmological examination including refraction; new patient 304 304 $0.00
2000F 32 30 $0.00
G8856 Referral to a physician for an otologic evaluation performed 14 14 $0.00
0503F 26 25 $0.00
V2104 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens 104 52 $0.00
V2744 Tint, photochromatic, per lens 142 69 $0.00
G8755 Most recent diastolic blood pressure >= 90 mmhg 36 31 $0.00
90673 13 12 $0.00