| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,285 |
1,266 |
$53K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,278 |
1,264 |
$44K |
| 92250 |
|
602 |
574 |
$17K |
| 92015 |
Determination of refractive state |
2,619 |
2,586 |
$8K |
| 92225 |
|
12 |
12 |
$474.72 |
| V2020 |
Frames, purchases |
133 |
133 |
$460.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
40 |
40 |
$252.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
560 |
555 |
$0.00 |
| 2033F |
|
13 |
13 |
$0.00 |
| 2023F |
|
12 |
12 |
$0.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
194 |
191 |
$0.00 |