| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,683 |
2,607 |
$223K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,267 |
2,163 |
$160K |
| V2020 |
Frames, purchases |
1,944 |
1,938 |
$127K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,471 |
1,406 |
$78K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
871 |
870 |
$51K |
| 92015 |
Determination of refractive state |
3,748 |
3,565 |
$44K |
| 92083 |
|
619 |
600 |
$27K |
| 92133 |
|
574 |
557 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
303 |
302 |
$10K |
| 92250 |
|
335 |
314 |
$8K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
56 |
56 |
$5K |
| V2025 |
Deluxe frame |
27 |
27 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
280 |
275 |
$756.91 |
| 92002 |
|
14 |
13 |
$552.40 |
| 76514 |
|
26 |
24 |
$225.23 |