| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
555 |
534 |
$57K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
327 |
327 |
$48K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
192 |
181 |
$14K |
| 76512 |
|
171 |
122 |
$11K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
57 |
57 |
$9K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
72 |
67 |
$6K |
| 92250 |
|
153 |
153 |
$4K |
| 92201 |
|
142 |
142 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
13 |
13 |
$2K |
| 92202 |
|
119 |
117 |
$1K |
| 92286 |
|
24 |
24 |
$704.31 |
| 92015 |
Determination of refractive state |
64 |
64 |
$0.00 |