| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,768 |
5,178 |
$360K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,064 |
2,764 |
$256K |
| 92015 |
Determination of refractive state |
13,571 |
11,679 |
$152K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,779 |
1,551 |
$88K |
| V2020 |
Frames, purchases |
2,915 |
2,714 |
$64K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
565 |
495 |
$23K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
280 |
232 |
$14K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
129 |
110 |
$12K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
140 |
115 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
51 |
47 |
$5K |
| 92250 |
|
210 |
184 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
31 |
28 |
$2K |
| 92136 |
|
58 |
54 |
$1K |
| 92083 |
|
39 |
25 |
$1K |
| 92133 |
|
41 |
27 |
$555.96 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
17 |
13 |
$527.66 |