| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
3,936 |
3,318 |
$512K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,863 |
957 |
$21K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
736 |
455 |
$13K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
518 |
319 |
$8K |
| 92250 |
|
228 |
148 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
408 |
226 |
$3K |
| 92015 |
Determination of refractive state |
1,155 |
813 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
293 |
161 |
$799.16 |
| 92133 |
|
41 |
24 |
$667.43 |
| 92020 |
|
23 |
14 |
$221.62 |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
15 |
13 |
$115.95 |
| V2020 |
Frames, purchases |
32 |
32 |
$76.72 |