| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
304 |
287 |
$12K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
43 |
42 |
$5K |
| 92201 |
|
191 |
176 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
96 |
93 |
$3K |
| 92202 |
|
118 |
117 |
$1K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
31 |
31 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
14 |
14 |
$733.44 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
13 |
$566.00 |
| 92015 |
Determination of refractive state |
43 |
42 |
$156.41 |
| 99174 |
|
12 |
12 |
$99.84 |