| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
263 |
175 |
$22K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
428 |
287 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
461 |
328 |
$11K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
74 |
43 |
$3K |
| 92015 |
Determination of refractive state |
536 |
346 |
$2K |
| 92250 |
|
54 |
42 |
$215.94 |
| 92133 |
|
13 |
13 |
$176.30 |
| 92134 |
|
12 |
12 |
$0.00 |