| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,755 |
3,725 |
$175K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,766 |
2,755 |
$124K |
| 92015 |
Determination of refractive state |
4,803 |
4,759 |
$63K |
| 92310 |
|
197 |
197 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
155 |
150 |
$8K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
96 |
94 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
147 |
139 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$240.00 |
| 92202 |
|
30 |
30 |
$235.74 |
| 92225 |
|
13 |
12 |
$169.40 |