| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
219 |
204 |
$7K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
437 |
435 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
414 |
414 |
$4K |
| 92015 |
Determination of refractive state |
1,358 |
1,358 |
$3K |
| 68761 |
|
28 |
14 |
$2K |
| 92250 |
|
29 |
29 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$259.20 |