| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,404 |
2,163 |
$158K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,872 |
1,740 |
$158K |
| V2020 |
Frames, purchases |
526 |
478 |
$7K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
532 |
486 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
338 |
309 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
129 |
119 |
$2K |
| 92250 |
|
33 |
27 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
18 |
13 |
$673.38 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
26 |
26 |
$371.05 |
| 92015 |
Determination of refractive state |
12 |
12 |
$0.00 |