| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,228 |
2,179 |
$173K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,852 |
1,809 |
$112K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
842 |
823 |
$77K |
| 92285 |
|
1,123 |
1,071 |
$44K |
| V2020 |
Frames, purchases |
1,918 |
1,815 |
$44K |
| 92250 |
|
673 |
641 |
$34K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
930 |
605 |
$14K |
| 92002 |
|
161 |
159 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
254 |
190 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
87 |
87 |
$4K |
| 92015 |
Determination of refractive state |
1,685 |
1,649 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
817 |
770 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
27 |
24 |
$1K |
| V2756 |
Eye glass case |
680 |
656 |
$668.52 |