| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
414 |
395 |
$33K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
351 |
346 |
$20K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
187 |
175 |
$18K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
907 |
801 |
$17K |
| V2020 |
Frames, purchases |
995 |
878 |
$14K |
| 92015 |
Determination of refractive state |
691 |
648 |
$8K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
144 |
141 |
$8K |
| 92133 |
|
12 |
12 |
$379.25 |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
16 |
13 |
$286.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
12 |
$274.56 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
31 |
28 |
$13.00 |