| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,130 |
2,083 |
$131K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,127 |
1,105 |
$98K |
| V2020 |
Frames, purchases |
3,084 |
2,930 |
$74K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,260 |
1,123 |
$26K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
383 |
372 |
$17K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
140 |
135 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
656 |
557 |
$2K |
| 92015 |
Determination of refractive state |
4,103 |
4,016 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
64 |
49 |
$2K |
| V2756 |
Eye glass case |
1,688 |
1,614 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
111 |
91 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
30 |
29 |
$815.36 |
| 92133 |
|
16 |
14 |
$368.66 |