| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,900 |
1,877 |
$119K |
| V2020 |
Frames, purchases |
1,663 |
1,632 |
$40K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
857 |
855 |
$40K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
428 |
424 |
$10K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
360 |
357 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
33 |
33 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
61 |
58 |
$2K |
| 92002 |
|
12 |
12 |
$673.38 |
| V2756 |
Eye glass case |
549 |
547 |
$589.68 |
| 92015 |
Determination of refractive state |
748 |
729 |
$90.30 |