| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,423 |
1,255 |
$75K |
| 92250 |
|
886 |
768 |
$27K |
| V2020 |
Frames, purchases |
227 |
206 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
48 |
41 |
$4K |
| 92202 |
|
317 |
288 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
140 |
121 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
16 |
14 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
43 |
33 |
$875.10 |
| 92015 |
Determination of refractive state |
45 |
40 |
$518.70 |
| 92020 |
|
40 |
38 |
$455.98 |
| 92225 |
|
34 |
14 |
$378.46 |
| 92226 |
|
32 |
12 |
$223.84 |