| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
840 |
835 |
$25K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
214 |
203 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
91 |
91 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
104 |
102 |
$2K |
| 92015 |
Determination of refractive state |
63 |
63 |
$828.34 |
| 92250 |
|
57 |
26 |
$489.49 |