| Code | Description | Claims | Beneficiaries | Total Paid |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,722 |
4,722 |
$251K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,567 |
2,566 |
$182K |
| 92015 |
Determination of refractive state |
7,294 |
7,292 |
$96K |
| 92250 |
|
134 |
134 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
44 |
42 |
$2K |
| G8785 |
Blood pressure reading not documented, reason not given |
73 |
73 |
$0.00 |
| G9905 |
Patient not screened for tobacco use |
117 |
117 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
5,064 |
5,026 |
$0.00 |
| G9902 |
Patient screened for tobacco use and identified as a tobacco user |
37 |
37 |
$0.00 |