| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
931 |
724 |
$54K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
597 |
461 |
$23K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
132 |
105 |
$10K |
| V2020 |
Frames, purchases |
728 |
657 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
80 |
68 |
$4K |
| 92002 |
|
63 |
53 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
152 |
139 |
$2K |
| 92250 |
|
95 |
46 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
28 |
28 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
31 |
26 |
$1K |
| 92133 |
|
29 |
14 |
$300.81 |
| 92015 |
Determination of refractive state |
50 |
49 |
$0.00 |