| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,765 |
1,736 |
$113K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,425 |
2,380 |
$101K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,771 |
1,085 |
$53K |
| V2020 |
Frames, purchases |
3,362 |
2,848 |
$42K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
592 |
587 |
$23K |
| V2207 |
Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens |
697 |
688 |
$21K |
| 92341 |
|
1,028 |
1,004 |
$19K |
| V2220 |
Bifocal add over 3.25d |
782 |
765 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
144 |
142 |
$8K |
| 92250 |
|
119 |
118 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
112 |
56 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,562 |
924 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
63 |
63 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
43 |
42 |
$986.16 |