| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,371 |
4,946 |
$390K |
| V2020 |
Frames, purchases |
9,249 |
8,364 |
$269K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,490 |
2,336 |
$225K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,165 |
3,104 |
$145K |
| 92015 |
Determination of refractive state |
9,409 |
8,962 |
$132K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,255 |
832 |
$35K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
463 |
428 |
$30K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
531 |
345 |
$12K |
| 92250 |
|
366 |
339 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
60 |
57 |
$5K |
| V2303 |
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens |
23 |
12 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
22 |
16 |
$350.78 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16 |
13 |
$0.00 |