| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,189 |
3,162 |
$110K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
435 |
435 |
$23K |
| 92015 |
Determination of refractive state |
1,372 |
1,370 |
$12K |
| V2020 |
Frames, purchases |
481 |
481 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
99 |
89 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
38 |
38 |
$2K |
| 92250 |
|
79 |
79 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16 |
14 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
31 |
24 |
$47.00 |