| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
1,535 |
1,416 |
$57K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
793 |
761 |
$53K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
387 |
374 |
$20K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
313 |
286 |
$17K |
| 92015 |
Determination of refractive state |
2,116 |
2,009 |
$15K |
| 92310 |
|
89 |
85 |
$4K |
| 99072 |
|
170 |
150 |
$3K |
| 92082 |
|
37 |
34 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18 |
13 |
$1K |
| 92002 |
|
12 |
12 |
$424.56 |
| S9986 |
Not medically necessary service (patient is aware that service not medically necessary) |
37 |
37 |
$0.00 |
| S9999 |
Sales tax |
14 |
14 |
$0.00 |