| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,455 |
3,336 |
$210K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,782 |
1,749 |
$156K |
| V2020 |
Frames, purchases |
3,543 |
3,184 |
$79K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,785 |
2,449 |
$64K |
| 92250 |
|
214 |
199 |
$8K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
121 |
107 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
86 |
67 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
18 |
12 |
$801.60 |
| V2756 |
Eye glass case |
490 |
463 |
$483.84 |
| 92015 |
Determination of refractive state |
5,372 |
5,212 |
$15.05 |
| 92285 |
|
14 |
13 |
$0.00 |