WASHINGTON EYE SPECIALISTS LLC

$339K

Total Medicaid Paid

13,699

Total Claims

11,974

Beneficiaries

20

Codes Billed

2018-01

First Month

2019-08

Last Month

Authorized Official	GANCAYCO, TED (ADMINISTRATOR)
NPI Enumeration Date	11/28/2006

Year	Claims	Total Paid
2018	7,960	$212K
2019	5,739	$128K

Code	Description	Claims	Beneficiaries	Total Paid
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	2,039	1,781	$131K
92014	Ophthalmological services: medical examination and evaluation, comprehensive, established patient	3,364	2,931	$83K
92083		1,456	1,285	$25K
92250		1,480	1,293	$22K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	441	398	$19K
92012	Ophthalmological services: medical examination and evaluation, intermediate, established patient	642	550	$11K
92133		1,066	947	$10K
92004	Ophthalmological services: medical examination and evaluation, comprehensive, new patient	295	261	$10K
92015	Determination of refractive state	1,484	1,271	$9K
92134		618	550	$5K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	82	56	$4K
95930		79	76	$3K
92020		403	360	$3K
99244	Office or other outpatient consultation, moderate to high complexity	13	13	$2K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	14	14	$2K
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	36	17	$775.94
67028	Intravitreal injection of a pharmacologic agent	19	13	$520.39
76514		125	121	$410.39
J9035	Injection, bevacizumab, 10 mg	19	13	$339.89
92136		24	24	$236.47

Medicaid Provider Spending