| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
222 |
197 |
$19K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
176 |
156 |
$10K |
| V2020 |
Frames, purchases |
123 |
123 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
132 |
115 |
$5K |
| 92226 |
|
56 |
56 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
40 |
30 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
81 |
79 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
104 |
104 |
$780.00 |
| 92083 |
|
12 |
12 |
$680.88 |
| 76514 |
|
57 |
52 |
$504.42 |
| 92250 |
|
92 |
92 |
$319.15 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
85 |
85 |
$19.50 |