| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
668 |
660 |
$24K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
277 |
272 |
$13K |
| 92083 |
|
180 |
179 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
174 |
171 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
292 |
144 |
$6K |
| 92285 |
|
344 |
341 |
$5K |
| 92082 |
|
82 |
80 |
$3K |
| 92020 |
|
218 |
211 |
$2K |
| V2020 |
Frames, purchases |
183 |
176 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$668.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$561.80 |
| 76514 |
|
74 |
69 |
$359.55 |
| 92201 |
|
14 |
14 |
$188.90 |
| 92015 |
Determination of refractive state |
78 |
78 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
58 |
29 |
$0.00 |