| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
56 |
56 |
$7K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
163 |
158 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
78 |
71 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
27 |
24 |
$2K |
| 92083 |
|
15 |
15 |
$670.14 |
| 92133 |
|
14 |
14 |
$410.73 |
| 92134 |
|
14 |
14 |
$353.01 |
| 76514 |
|
14 |
14 |
$127.07 |
| 92015 |
Determination of refractive state |
37 |
37 |
$79.31 |