| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
172 |
160 |
$15K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
73 |
59 |
$6K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
65 |
53 |
$3K |
| 92015 |
Determination of refractive state |
104 |
103 |
$1K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
16 |
14 |
$994.56 |
| 92136 |
|
36 |
14 |
$854.31 |
| 99072 |
|
39 |
32 |
$220.00 |