| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
3,696 |
3,501 |
$202K |
| V2020 |
Frames, purchases |
6,078 |
5,669 |
$161K |
| 92015 |
Determination of refractive state |
6,360 |
5,978 |
$82K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,022 |
1,892 |
$81K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,614 |
1,494 |
$66K |
| 92002 |
|
1,116 |
1,056 |
$54K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
369 |
304 |
$34K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
238 |
220 |
$24K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
485 |
413 |
$22K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
271 |
249 |
$11K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
129 |
123 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
84 |
80 |
$5K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
37 |
37 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
15 |
15 |
$2K |
| 92083 |
|
28 |
27 |
$2K |
| V2755 |
U-v lens, per lens |
32 |
32 |
$480.00 |