| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,119 |
2,116 |
$121K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,449 |
1,446 |
$104K |
| 92250 |
|
1,526 |
1,522 |
$67K |
| 92083 |
|
1,367 |
1,366 |
$64K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,468 |
1,297 |
$41K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,000 |
933 |
$40K |
| 68761 |
|
468 |
235 |
$36K |
| 92060 |
|
916 |
915 |
$33K |
| 92285 |
|
1,138 |
1,138 |
$32K |
| V2020 |
Frames, purchases |
2,305 |
2,272 |
$27K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
184 |
103 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
36 |
36 |
$3K |
| 92082 |
|
55 |
55 |
$2K |
| 92133 |
|
50 |
50 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
19 |
19 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
629 |
349 |
$925.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
13 |
$411.70 |
| 92134 |
|
14 |
14 |
$390.26 |
| 92202 |
|
26 |
24 |
$383.28 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
76 |
38 |
$246.48 |