| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,330 |
4,228 |
$237K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,698 |
2,613 |
$130K |
| V2500 |
Contact lens, pmma, spherical, per lens |
130 |
128 |
$83K |
| 92060 |
|
1,494 |
1,476 |
$50K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
237 |
236 |
$20K |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
27 |
25 |
$15K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
217 |
204 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
192 |
95 |
$4K |
| 92250 |
|
56 |
55 |
$2K |
| 92201 |
|
14 |
14 |
$276.92 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
306 |
151 |
$260.00 |
| 92310 |
|
14 |
13 |
$0.00 |
| 92015 |
Determination of refractive state |
3,955 |
3,831 |
$0.00 |