| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,714 |
4,678 |
$453K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,671 |
3,666 |
$437K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
4,145 |
3,685 |
$284K |
| 68761 |
|
2,956 |
1,483 |
$239K |
| 92250 |
|
7,029 |
7,013 |
$237K |
| 92083 |
|
3,837 |
3,815 |
$187K |
| 92133 |
|
2,325 |
2,319 |
$64K |
| 92020 |
|
2,478 |
2,468 |
$52K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
615 |
580 |
$39K |
| 76513 |
|
205 |
205 |
$20K |
| 92226 |
|
969 |
565 |
$20K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
244 |
241 |
$19K |
| 92015 |
Determination of refractive state |
1,648 |
1,638 |
$17K |
| 92225 |
|
751 |
433 |
$17K |
| 65778 |
|
28 |
26 |
$16K |
| 92202 |
|
947 |
934 |
$10K |
| 92201 |
|
467 |
464 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
434 |
218 |
$9K |
| 92275 |
|
56 |
56 |
$8K |
| 92273 |
|
82 |
82 |
$6K |
| 92025 |
|
187 |
186 |
$5K |
| 76514 |
|
637 |
635 |
$5K |
| V2020 |
Frames, purchases |
265 |
260 |
$3K |
| 92134 |
|
112 |
111 |
$2K |
| 92286 |
|
26 |
26 |
$410.56 |
| 83516 |
|
58 |
40 |
$190.04 |
| 99072 |
|
223 |
215 |
$18.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
66 |
32 |
$0.00 |
| 83861 |
|
24 |
13 |
$0.00 |