| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
7,247 |
7,001 |
$636K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,746 |
2,615 |
$285K |
| 92015 |
Determination of refractive state |
10,254 |
9,870 |
$128K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
685 |
604 |
$40K |
| 92250 |
|
470 |
452 |
$26K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
82 |
82 |
$3K |
| 92310 |
|
47 |
45 |
$2K |
| 92133 |
|
27 |
27 |
$943.72 |
| V2020 |
Frames, purchases |
14 |
14 |
$700.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13 |
13 |
$169.00 |