| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92201 |
|
1,300 |
1,151 |
$62K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
328 |
327 |
$36K |
| 92225 |
|
621 |
561 |
$23K |
| 92015 |
Determination of refractive state |
1,766 |
1,590 |
$21K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
301 |
265 |
$21K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
311 |
310 |
$20K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
50 |
44 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
28 |
28 |
$1K |