| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
9,126 |
8,862 |
$563K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,257 |
4,119 |
$340K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
8,548 |
8,181 |
$302K |
| V2020 |
Frames, purchases |
10,963 |
10,682 |
$183K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
3,044 |
2,767 |
$102K |
| 92015 |
Determination of refractive state |
9,380 |
9,195 |
$88K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
548 |
533 |
$19K |
| 92250 |
|
485 |
466 |
$6K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
38 |
38 |
$3K |
| 92133 |
|
188 |
185 |
$2K |
| 92083 |
|
81 |
81 |
$2K |
| 92134 |
|
288 |
250 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14 |
13 |
$415.30 |
| 92020 |
|
13 |
12 |
$110.79 |
| 3072F |
|
545 |
502 |
$0.00 |
| 2033F |
|
2,913 |
2,820 |
$0.00 |