| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,392 |
1,312 |
$143K |
| 92250 |
|
1,395 |
1,280 |
$66K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
679 |
626 |
$51K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
320 |
290 |
$37K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
521 |
443 |
$30K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
141 |
128 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
195 |
170 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
103 |
100 |
$8K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
51 |
51 |
$7K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
12 |
12 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
75 |
75 |
$3K |
| V2020 |
Frames, purchases |
76 |
75 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
51 |
44 |
$1K |
| V2750 |
Anti-reflective coating, per lens |
48 |
48 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
64 |
62 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
75 |
75 |
$1K |
| 92015 |
Determination of refractive state |
66 |
66 |
$109.30 |