| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,463 |
1,347 |
$86K |
| V2020 |
Frames, purchases |
1,736 |
1,607 |
$68K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
278 |
255 |
$23K |
| 92015 |
Determination of refractive state |
3,554 |
3,174 |
$17K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
208 |
192 |
$9K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
761 |
710 |
$7K |
| 92250 |
|
115 |
101 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
41 |
41 |
$2K |
| 92081 |
|
85 |
69 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
19 |
12 |
$463.05 |
| 99072 |
|
150 |
134 |
$0.00 |