| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
449 |
424 |
$31K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
189 |
175 |
$15K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
442 |
416 |
$11K |
| V2020 |
Frames, purchases |
612 |
559 |
$8K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
261 |
255 |
$3K |
| V2799 |
Vision item or service, miscellaneous |
123 |
117 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
15 |
13 |
$904.77 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
14 |
14 |
$297.30 |
| 92015 |
Determination of refractive state |
655 |
587 |
$0.00 |