| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92065 |
|
2,841 |
776 |
$66K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
982 |
967 |
$61K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
891 |
832 |
$32K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
461 |
458 |
$24K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,929 |
513 |
$23K |
| 92060 |
|
442 |
435 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
609 |
306 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
274 |
138 |
$6K |
| V2020 |
Frames, purchases |
289 |
289 |
$4K |
| 92015 |
Determination of refractive state |
47 |
44 |
$580.64 |
| 92250 |
|
13 |
13 |
$445.00 |
| 92225 |
|
24 |
12 |
$326.20 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,712 |
859 |
$35.00 |