| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
702 |
659 |
$13K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
200 |
192 |
$12K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
700 |
660 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
446 |
423 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
138 |
132 |
$8K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
42 |
41 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
31 |
31 |
$2K |
| 92285 |
|
90 |
80 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
12 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15 |
13 |
$639.57 |
| 92250 |
|
15 |
15 |
$612.12 |
| 92133 |
|
13 |
12 |
$266.37 |
| 92015 |
Determination of refractive state |
280 |
250 |
$80.00 |