| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,787 |
2,774 |
$295K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,999 |
1,987 |
$252K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,208 |
1,119 |
$95K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,276 |
1,224 |
$91K |
| 92250 |
|
1,215 |
1,209 |
$44K |
| 92015 |
Determination of refractive state |
3,734 |
3,702 |
$35K |
| V2020 |
Frames, purchases |
1,027 |
1,015 |
$26K |
| 92002 |
|
161 |
156 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
62 |
62 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
141 |
137 |
$4K |
| 92081 |
|
109 |
108 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
36 |
36 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
159 |
120 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
61 |
38 |
$1K |
| 92060 |
|
12 |
12 |
$735.39 |