| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,968 |
3,803 |
$399K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,766 |
1,766 |
$279K |
| 92083 |
|
1,372 |
1,369 |
$77K |
| 92250 |
|
1,842 |
1,829 |
$70K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
515 |
486 |
$37K |
| 92015 |
Determination of refractive state |
1,451 |
1,448 |
$20K |
| 92133 |
|
305 |
304 |
$11K |
| V2020 |
Frames, purchases |
278 |
276 |
$9K |
| 92225 |
|
193 |
121 |
$7K |
| 92226 |
|
183 |
119 |
$6K |
| 92020 |
|
213 |
212 |
$5K |
| 92202 |
|
411 |
398 |
$5K |
| 76516 |
|
40 |
40 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
49 |
24 |
$756.88 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
86 |
42 |
$0.00 |