| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,297 |
1,237 |
$55K |
| 92083 |
|
1,150 |
1,137 |
$34K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
573 |
565 |
$31K |
| 92250 |
|
1,073 |
999 |
$27K |
| 92100 |
|
539 |
482 |
$19K |
| 92133 |
|
706 |
698 |
$13K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
291 |
281 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
109 |
107 |
$4K |
| 92202 |
|
581 |
571 |
$4K |
| 92015 |
Determination of refractive state |
354 |
351 |
$2K |
| 92285 |
|
154 |
154 |
$2K |
| 76513 |
|
32 |
27 |
$1K |
| 92134 |
|
87 |
87 |
$1K |
| 92225 |
|
99 |
75 |
$594.28 |
| 76514 |
|
83 |
79 |
$459.11 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
12 |
$323.44 |
| V2020 |
Frames, purchases |
16 |
15 |
$320.00 |
| 93886 |
|
28 |
27 |
$133.63 |
| 93892 |
|
28 |
27 |
$0.00 |
| 93890 |
|
28 |
27 |
$0.00 |