| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
970 |
905 |
$51K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
442 |
411 |
$30K |
| 92015 |
Determination of refractive state |
2,103 |
1,974 |
$15K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
69 |
52 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
56 |
52 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
32 |
31 |
$878.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
48 |
47 |
$201.61 |