| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,507 |
3,415 |
$216K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,580 |
2,525 |
$202K |
| V2020 |
Frames, purchases |
2,539 |
2,432 |
$97K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,618 |
1,299 |
$68K |
| 92015 |
Determination of refractive state |
6,998 |
6,612 |
$32K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
549 |
286 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
344 |
183 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
112 |
104 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
49 |
40 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
51 |
28 |
$1K |
| V2715 |
Prism, per lens |
100 |
49 |
$1K |