ULTIMATE EYECARE SANTA FE, LLC
NPI: 1891182721
· SANTA FE, NM 87505
· Optometrist
· NPI assigned 04/17/2015
$314K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
13 |
$2K |
| 2020 |
250 |
$32K |
| 2021 |
680 |
$48K |
| 2022 |
946 |
$73K |
| 2023 |
1,064 |
$75K |
| 2024 |
1,059 |
$83K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,159 |
1,157 |
$183K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
431 |
431 |
$57K |
| 92250 |
|
1,075 |
1,072 |
$55K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
91 |
91 |
$9K |
| 92015 |
Determination of refractive state |
1,228 |
1,226 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
28 |
28 |
$2K |