| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,375 |
1,375 |
$197K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,051 |
1,051 |
$122K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
308 |
247 |
$23K |
| 92250 |
|
502 |
502 |
$17K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$2K |
| 92134 |
|
41 |
39 |
$1K |
| 92002 |
|
12 |
12 |
$995.35 |
| 92015 |
Determination of refractive state |
54 |
54 |
$242.28 |
| 76514 |
|
13 |
13 |
$104.61 |