| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,929 |
1,844 |
$115K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,798 |
1,764 |
$97K |
| 92015 |
Determination of refractive state |
3,179 |
3,014 |
$21K |
| 92250 |
|
726 |
650 |
$15K |
| V2020 |
Frames, purchases |
200 |
200 |
$14K |
| V2025 |
Deluxe frame |
194 |
194 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
238 |
237 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
139 |
123 |
$8K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
72 |
63 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
348 |
348 |
$2K |
| V2750 |
Anti-reflective coating, per lens |
158 |
158 |
$512.23 |
| 99072 |
|
48 |
35 |
$5.28 |