| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,678 |
1,671 |
$78K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,384 |
1,381 |
$69K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,468 |
1,445 |
$58K |
| 92083 |
|
790 |
790 |
$38K |
| 92133 |
|
749 |
749 |
$23K |
| 92020 |
|
1,062 |
1,060 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
804 |
403 |
$14K |
| 92202 |
|
375 |
374 |
$7K |
| V2020 |
Frames, purchases |
796 |
795 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
143 |
141 |
$5K |
| 92250 |
|
92 |
92 |
$4K |
| 92015 |
Determination of refractive state |
2,282 |
2,278 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
350 |
175 |
$3K |
| 76514 |
|
377 |
377 |
$3K |
| 92002 |
|
101 |
101 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$1K |
| 92134 |
|
26 |
26 |
$780.52 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
27 |
25 |
$610.48 |
| V2755 |
U-v lens, per lens |
424 |
212 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
270 |
135 |
$0.00 |
| 2023F |
|
42 |
42 |
$0.00 |