| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,699 |
1,554 |
$135K |
| V2020 |
Frames, purchases |
3,107 |
2,945 |
$131K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,283 |
1,232 |
$84K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,219 |
1,143 |
$43K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,093 |
1,044 |
$30K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,059 |
1,023 |
$26K |
| 92015 |
Determination of refractive state |
2,498 |
2,328 |
$21K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
76 |
66 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
18 |
16 |
$646.50 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
12 |
$294.00 |