| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,538 |
3,321 |
$161K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,098 |
1,308 |
$82K |
| V2020 |
Frames, purchases |
2,698 |
2,582 |
$51K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
147 |
90 |
$7K |
| 92225 |
|
324 |
320 |
$3K |
| 92202 |
|
548 |
542 |
$3K |
| 92002 |
|
99 |
99 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
34 |
34 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
56 |
28 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
14 |
$815.53 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
14 |
14 |
$560.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,377 |
1,125 |
$220.00 |