| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,131 |
1,009 |
$92K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,221 |
1,095 |
$81K |
| V2020 |
Frames, purchases |
1,931 |
1,660 |
$25K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,068 |
1,790 |
$24K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,317 |
1,130 |
$22K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
160 |
135 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
56 |
53 |
$1K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
14 |
12 |
$757.46 |
| 92015 |
Determination of refractive state |
1,926 |
1,678 |
$1.92 |