| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,171 |
852 |
$27K |
| 68761 |
|
532 |
236 |
$19K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
271 |
182 |
$4K |
| 92133 |
|
218 |
159 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
81 |
55 |
$1K |
| 92015 |
Determination of refractive state |
53 |
40 |
$641.45 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
37 |
30 |
$635.24 |
| V2020 |
Frames, purchases |
38 |
32 |
$513.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
23 |
21 |
$510.55 |
| 92250 |
|
17 |
13 |
$184.37 |