| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
1,214 |
1,180 |
$22K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
836 |
814 |
$22K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
60 |
57 |
$3K |
| 92250 |
|
83 |
81 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
35 |
34 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
21 |
12 |
$879.90 |
| V2020 |
Frames, purchases |
15 |
13 |
$285.20 |