| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,695 |
1,609 |
$162K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
416 |
395 |
$37K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
264 |
232 |
$14K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
37 |
27 |
$2K |
| 92250 |
|
42 |
42 |
$2K |
| 92133 |
|
17 |
17 |
$514.96 |
| 92015 |
Determination of refractive state |
2,221 |
2,088 |
$335.75 |
| 92020 |
|
13 |
13 |
$263.16 |
| 76514 |
|
12 |
12 |
$90.66 |