| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,736 |
1,596 |
$114K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,739 |
1,657 |
$87K |
| V2020 |
Frames, purchases |
3,240 |
3,010 |
$44K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
486 |
459 |
$39K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
536 |
488 |
$27K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,399 |
1,322 |
$22K |
| 92002 |
|
253 |
243 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
287 |
266 |
$4K |
| 92250 |
|
151 |
92 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
12 |
$689.15 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
40 |
36 |
$594.94 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
24 |
17 |
$548.20 |
| 92133 |
|
14 |
12 |
$231.21 |
| 92015 |
Determination of refractive state |
1,445 |
1,361 |
$0.00 |