| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,572 |
4,259 |
$205K |
| 92015 |
Determination of refractive state |
7,384 |
6,809 |
$157K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,297 |
1,267 |
$60K |
| 92250 |
|
1,473 |
1,396 |
$44K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
736 |
663 |
$31K |
| 92083 |
|
1,170 |
1,109 |
$19K |
| 92020 |
|
1,623 |
1,513 |
$17K |
| 92133 |
|
540 |
521 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
39 |
38 |
$3K |
| 92134 |
|
191 |
191 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
381 |
343 |
$747.47 |
| 92201 |
|
197 |
174 |
$643.56 |
| 76514 |
|
61 |
58 |
$371.73 |
| 92136 |
|
12 |
12 |
$353.19 |
| 92025 |
|
12 |
12 |
$149.79 |
| 92202 |
|
34 |
31 |
$123.26 |
| V2020 |
Frames, purchases |
461 |
458 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
26 |
13 |
$0.00 |
| 99072 |
|
13 |
13 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
894 |
468 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
166 |
83 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
146 |
72 |
$0.00 |