| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,891 |
1,885 |
$106K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,058 |
993 |
$41K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
341 |
341 |
$24K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,011 |
1,011 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
249 |
227 |
$9K |
| 92226 |
|
729 |
382 |
$8K |
| 92250 |
|
323 |
323 |
$7K |
| 92083 |
|
228 |
226 |
$7K |
| 92015 |
Determination of refractive state |
1,110 |
1,109 |
$5K |
| 92225 |
|
190 |
108 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
214 |
192 |
$1K |
| 92202 |
|
199 |
195 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13 |
13 |
$319.20 |
| 92286 |
|
13 |
13 |
$307.52 |
| 92133 |
|
12 |
12 |
$298.68 |
| 3072F |
|
242 |
237 |
$0.00 |