| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,686 |
1,657 |
$101K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,262 |
1,246 |
$100K |
| V2020 |
Frames, purchases |
925 |
920 |
$28K |
| 92015 |
Determination of refractive state |
1,298 |
1,267 |
$14K |
| 92202 |
|
1,265 |
1,251 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
942 |
506 |
$5K |
| 92226 |
|
437 |
238 |
$5K |
| 92225 |
|
195 |
102 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
32 |
27 |
$2K |
| 92250 |
|
12 |
12 |
$172.72 |