| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,275 |
2,271 |
$16K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
334 |
310 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,067 |
1,067 |
$5K |
| 92250 |
|
109 |
109 |
$4K |
| V2020 |
Frames, purchases |
2,538 |
2,537 |
$0.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
152 |
152 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,846 |
958 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,194 |
1,155 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,425 |
766 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
217 |
115 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
112 |
112 |
$0.00 |