| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
123 |
122 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
26 |
26 |
$1K |
| 92201 |
|
74 |
74 |
$789.59 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
33 |
33 |
$633.26 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
20 |
20 |
$350.04 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
15 |
15 |
$172.16 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
27 |
27 |
$134.40 |
| 92133 |
|
12 |
12 |
$52.81 |
| 2022F |
|
17 |
17 |
$0.00 |