| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
628 |
552 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
30 |
25 |
$686.40 |
| 92250 |
|
338 |
328 |
$635.49 |
| 92134 |
|
102 |
84 |
$458.37 |
| 92133 |
|
198 |
188 |
$208.27 |
| 92083 |
|
68 |
65 |
$156.80 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
167 |
154 |
$133.60 |
| 76512 |
|
45 |
28 |
$95.04 |
| 92136 |
|
94 |
31 |
$63.22 |
| 92286 |
|
46 |
29 |
$12.00 |
| 92015 |
Determination of refractive state |
35 |
33 |
$8.80 |
| 92025 |
|
43 |
26 |
$0.00 |
| 92201 |
|
104 |
101 |
$0.00 |
| 92202 |
|
105 |
102 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
14 |
14 |
$0.00 |
| 92285 |
|
45 |
31 |
$0.00 |