| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
1,101 |
1,080 |
$18K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
469 |
412 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
159 |
156 |
$8K |
| 92250 |
|
447 |
377 |
$2K |
| 92285 |
|
420 |
357 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
13 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$771.21 |
| 92225 |
|
201 |
153 |
$737.47 |
| V2020 |
Frames, purchases |
42 |
42 |
$561.00 |
| 65210 |
|
34 |
28 |
$308.09 |
| 67820 |
|
22 |
13 |
$209.57 |
| 92341 |
|
25 |
24 |
$80.91 |