| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,145 |
3,053 |
$115K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,515 |
2,449 |
$90K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,310 |
3,241 |
$68K |
| V2020 |
Frames, purchases |
4,147 |
4,068 |
$68K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
653 |
644 |
$20K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,879 |
1,843 |
$18K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
59 |
57 |
$3K |
| 92065 |
|
298 |
141 |
$2K |
| 92015 |
Determination of refractive state |
5,678 |
5,519 |
$25.09 |
| V2299 |
Specialty bifocal (by report) |
12 |
12 |
$0.00 |
| V2781 |
Progressive lens, per lens |
12 |
12 |
$0.00 |
| 2022F |
|
157 |
157 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
142 |
142 |
$0.00 |