| Code | Description | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
$283K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
$113K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
$90K |
| 92015 |
Determination of refractive state |
$70K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
$47K |
| 92250 |
|
$46K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
$20K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
$16K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
$8K |