| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
456 |
443 |
$18K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
658 |
607 |
$16K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
89 |
85 |
$2K |
| 92225 |
|
91 |
90 |
$2K |
| 92133 |
|
38 |
37 |
$890.59 |
| 92083 |
|
36 |
36 |
$576.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,444 |
1,424 |
$442.00 |
| V2020 |
Frames, purchases |
1,314 |
1,281 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
50 |
25 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
232 |
230 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
772 |
378 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,590 |
777 |
$0.00 |