| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,862 |
3,642 |
$169K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
835 |
755 |
$38K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,037 |
914 |
$28K |
| 92015 |
Determination of refractive state |
3,086 |
2,278 |
$20K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
618 |
545 |
$17K |
| V2020 |
Frames, purchases |
185 |
175 |
$11K |
| 99072 |
|
564 |
460 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
142 |
139 |
$9K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
79 |
70 |
$5K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
16 |
12 |
$4K |
| V2025 |
Deluxe frame |
139 |
135 |
$3K |
| 92136 |
|
39 |
25 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
24 |
12 |
$957.00 |
| 92134 |
|
29 |
25 |
$476.40 |
| V2756 |
Eye glass case |
300 |
284 |
$399.78 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$34.27 |
| S9999 |
Sales tax |
18 |
13 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$0.00 |