| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92060 |
|
9,917 |
9,610 |
$216K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
5,157 |
5,141 |
$186K |
| 92250 |
|
6,593 |
6,531 |
$177K |
| 92285 |
|
6,612 |
6,534 |
$131K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,469 |
1,449 |
$93K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,080 |
2,078 |
$87K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,281 |
2,092 |
$80K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,311 |
1,285 |
$63K |
| 76512 |
|
790 |
784 |
$51K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,306 |
1,222 |
$45K |
| 92202 |
|
1,211 |
1,208 |
$27K |
| 92015 |
Determination of refractive state |
4,664 |
4,648 |
$18K |
| 92134 |
|
726 |
717 |
$17K |
| 99050 |
|
1,280 |
1,232 |
$17K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
644 |
601 |
$15K |
| 92133 |
|
503 |
486 |
$11K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
350 |
343 |
$10K |
| 68761 |
|
127 |
82 |
$3K |
| 92132 |
|
109 |
109 |
$2K |
| 76514 |
|
101 |
100 |
$758.25 |
| V2020 |
Frames, purchases |
22 |
22 |
$440.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$298.56 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
14 |
14 |
$117.00 |
| 99072 |
|
51 |
51 |
$0.00 |