| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,037 |
4,031 |
$437K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
4,334 |
4,203 |
$305K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,614 |
1,612 |
$232K |
| 92250 |
|
4,488 |
4,486 |
$188K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,199 |
1,199 |
$152K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,325 |
1,323 |
$125K |
| V2020 |
Frames, purchases |
2,450 |
2,428 |
$92K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,391 |
1,338 |
$90K |
| 92083 |
|
1,588 |
1,585 |
$86K |
| 68761 |
|
433 |
419 |
$79K |
| 92015 |
Determination of refractive state |
2,612 |
2,608 |
$33K |
| 92133 |
|
913 |
913 |
$28K |
| 92020 |
|
949 |
947 |
$21K |
| 92134 |
|
540 |
540 |
$16K |
| 92025 |
|
414 |
412 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
472 |
425 |
$10K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
192 |
95 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
28 |
28 |
$3K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
15 |
15 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,288 |
643 |
$1K |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
28 |
28 |
$296.90 |
| 76514 |
|
16 |
16 |
$100.98 |