| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,601 |
4,386 |
$401K |
| V2020 |
Frames, purchases |
7,503 |
6,780 |
$258K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,557 |
2,425 |
$239K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,557 |
2,840 |
$128K |
| 92015 |
Determination of refractive state |
8,369 |
7,951 |
$111K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
926 |
856 |
$69K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,219 |
1,059 |
$62K |
| 92250 |
|
754 |
699 |
$21K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
292 |
224 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
117 |
96 |
$7K |
| V2755 |
U-v lens, per lens |
319 |
310 |
$7K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
34 |
24 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
42 |
27 |
$690.93 |