| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
535 |
492 |
$55K |
| 92083 |
|
869 |
837 |
$42K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
407 |
388 |
$42K |
| 92250 |
|
1,072 |
1,017 |
$35K |
| 92015 |
Determination of refractive state |
1,105 |
1,032 |
$17K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
141 |
138 |
$3K |
| V2020 |
Frames, purchases |
126 |
123 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
17 |
17 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
157 |
154 |
$913.86 |
| 92134 |
|
15 |
15 |
$524.70 |