| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
1,492 |
1,486 |
$61K |
| 92285 |
|
1,571 |
1,555 |
$39K |
| 92083 |
|
972 |
952 |
$35K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
307 |
307 |
$26K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
405 |
400 |
$23K |
| V2020 |
Frames, purchases |
956 |
948 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
802 |
421 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
105 |
105 |
$7K |
| 92226 |
|
519 |
296 |
$6K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
72 |
72 |
$4K |
| 92225 |
|
246 |
134 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
616 |
307 |
$300.00 |