| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
631 |
598 |
$73K |
| 92083 |
|
1,175 |
1,109 |
$56K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
569 |
540 |
$55K |
| 92250 |
|
1,496 |
1,391 |
$45K |
| 92015 |
Determination of refractive state |
1,581 |
1,476 |
$24K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
64 |
59 |
$6K |
| V2020 |
Frames, purchases |
118 |
110 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
27 |
27 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
25 |
25 |
$202.00 |