| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92065 |
|
5,620 |
1,513 |
$261K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,726 |
2,690 |
$169K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,945 |
1,919 |
$109K |
| 92015 |
Determination of refractive state |
2,793 |
2,705 |
$91K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,632 |
1,532 |
$87K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
3,709 |
905 |
$69K |
| 92060 |
|
906 |
891 |
$45K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
398 |
144 |
$32K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,373 |
1,362 |
$16K |
| 92250 |
|
329 |
324 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,160 |
584 |
$3K |
| 92545 |
|
195 |
85 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
64 |
56 |
$3K |
| 92002 |
|
79 |
79 |
$2K |
| 92225 |
|
92 |
48 |
$1K |
| 92341 |
|
129 |
128 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
528 |
271 |
$748.44 |
| V2020 |
Frames, purchases |
258 |
258 |
$546.61 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
132 |
66 |
$451.88 |
| 92133 |
|
14 |
14 |
$450.72 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
41 |
41 |
$380.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,064 |
1,036 |
$173.12 |