| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
197 |
190 |
$10K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
79 |
79 |
$6K |
| 92025 |
|
78 |
78 |
$2K |
| 92134 |
|
79 |
79 |
$2K |
| 92250 |
|
15 |
15 |
$625.68 |
| 92202 |
|
45 |
39 |
$601.12 |
| 95060 |
|
53 |
52 |
$361.79 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,076 |
1,076 |
$84.78 |
| 92015 |
Determination of refractive state |
1,772 |
1,771 |
$79.71 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
65 |
65 |
$0.00 |