| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,098 |
2,060 |
$130K |
| V2020 |
Frames, purchases |
2,142 |
2,043 |
$53K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,032 |
989 |
$23K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
257 |
250 |
$23K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
352 |
307 |
$10K |
| V2756 |
Eye glass case |
1,964 |
1,914 |
$2K |
| 92082 |
|
26 |
24 |
$583.93 |
| 92250 |
|
14 |
14 |
$253.22 |
| 92015 |
Determination of refractive state |
2,742 |
2,687 |
$45.15 |