| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,863 |
4,223 |
$379K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,953 |
1,717 |
$201K |
| V2020 |
Frames, purchases |
4,255 |
3,753 |
$158K |
| 92015 |
Determination of refractive state |
8,943 |
7,700 |
$111K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,142 |
935 |
$48K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,139 |
622 |
$32K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
34 |
26 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
119 |
96 |
$950.34 |
| V2750 |
Anti-reflective coating, per lens |
99 |
75 |
$68.74 |