| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,399 |
1,296 |
$103K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
253 |
253 |
$31K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
175 |
174 |
$20K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
92 |
92 |
$12K |
| 92250 |
|
235 |
235 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
88 |
88 |
$7K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$1K |
| 92015 |
Determination of refractive state |
57 |
57 |
$784.06 |