| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,190 |
1,188 |
$93K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,417 |
1,417 |
$81K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
553 |
553 |
$46K |
| V2020 |
Frames, purchases |
928 |
923 |
$28K |
| 92083 |
|
621 |
617 |
$26K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
288 |
278 |
$16K |
| 92015 |
Determination of refractive state |
3,986 |
3,976 |
$14K |
| 92250 |
|
301 |
301 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
196 |
196 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
64 |
64 |
$5K |
| 92133 |
|
109 |
109 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
28 |
28 |
$2K |
| 83861 |
|
13 |
13 |
$404.72 |
| 76514 |
|
61 |
61 |
$307.89 |
| 92020 |
|
12 |
12 |
$178.81 |