| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,018 |
951 |
$28K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
653 |
614 |
$24K |
| 92015 |
Determination of refractive state |
2,168 |
2,037 |
$23K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
642 |
584 |
$16K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
230 |
217 |
$10K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
237 |
216 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
127 |
125 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
15 |
$1K |
| 92341 |
|
25 |
25 |
$631.97 |
| V2020 |
Frames, purchases |
18 |
18 |
$306.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
14 |
14 |
$280.00 |
| 92083 |
|
14 |
14 |
$271.66 |
| 92133 |
|
28 |
25 |
$258.36 |
| 92134 |
|
61 |
54 |
$197.12 |