| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,921 |
2,768 |
$204K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,862 |
1,751 |
$157K |
| V2020 |
Frames, purchases |
5,819 |
5,463 |
$82K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
5,848 |
5,536 |
$75K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,670 |
3,422 |
$58K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
494 |
445 |
$25K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
956 |
909 |
$13K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
429 |
390 |
$5K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
158 |
145 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
63 |
38 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
37 |
25 |
$1K |
| 92250 |
|
16 |
14 |
$578.10 |
| V2780 |
Oversize lens, per lens |
54 |
49 |
$7.00 |
| 3072F |
|
19 |
12 |
$0.00 |