| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
655 |
611 |
$49K |
| 92250 |
|
775 |
717 |
$35K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
153 |
138 |
$12K |
| 92015 |
Determination of refractive state |
259 |
234 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
54 |
38 |
$2K |
| 92133 |
|
30 |
26 |
$452.20 |
| 92499 |
|
33 |
30 |
$323.36 |
| 92134 |
|
18 |
14 |
$61.60 |
| G8397 |
Dilated macular or fundus exam performed, including documentation of the presence or absence of macular edema and level of severity of retinopathy |
29 |
27 |
$0.00 |
| 5010F |
|
29 |
27 |
$0.00 |