| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
774 |
748 |
$24K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
573 |
552 |
$15K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
413 |
404 |
$14K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
971 |
966 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
242 |
198 |
$6K |
| 92083 |
|
389 |
373 |
$6K |
| 92225 |
|
110 |
54 |
$2K |
| 92015 |
Determination of refractive state |
706 |
702 |
$600.60 |
| 76514 |
|
33 |
33 |
$293.22 |
| 92145 |
|
28 |
26 |
$164.67 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
15 |
15 |
$100.00 |
| V2020 |
Frames, purchases |
933 |
924 |
$40.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
30 |
30 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
768 |
421 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
301 |
153 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$0.00 |