| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,473 |
1,273 |
$122K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,256 |
1,129 |
$88K |
| 92015 |
Determination of refractive state |
2,661 |
2,286 |
$32K |
| V2020 |
Frames, purchases |
311 |
303 |
$21K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
225 |
225 |
$14K |
| 92250 |
|
751 |
616 |
$13K |
| 92002 |
|
142 |
106 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
37 |
34 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
33 |
32 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
12 |
12 |
$61.80 |