| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
501 |
462 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
200 |
192 |
$7K |
| 92250 |
|
362 |
359 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
67 |
67 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
122 |
112 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
121 |
120 |
$3K |
| 92134 |
|
103 |
98 |
$860.81 |
| 92015 |
Determination of refractive state |
18 |
18 |
$542.98 |