WHITEHEAD, GLEN

$33K

Total Medicaid Paid

1,480

Total Claims

1,193

Beneficiaries

6

Codes Billed

2018-01

First Month

2019-01

Last Month

Year	Claims	Total Paid
2018	1,442	$32K
2019	38	$610.20

Code	Description	Claims	Beneficiaries	Total Paid
92015	Determination of refractive state	612	503	$11K
92060		480	332	$8K
92012	Ophthalmological services: medical examination and evaluation, intermediate, established patient	224	206	$7K
92004	Ophthalmological services: medical examination and evaluation, comprehensive, new patient	133	123	$5K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	18	17	$968.77
92014	Ophthalmological services: medical examination and evaluation, comprehensive, established patient	13	12	$495.99

Medicaid Provider Spending