| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,314 |
3,060 |
$214K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,482 |
1,354 |
$130K |
| V2020 |
Frames, purchases |
3,625 |
3,289 |
$78K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,237 |
790 |
$63K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,611 |
1,469 |
$39K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
399 |
188 |
$23K |
| 92015 |
Determination of refractive state |
1,595 |
1,432 |
$21K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
813 |
742 |
$21K |
| 92250 |
|
959 |
817 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,100 |
1,908 |
$11K |
| V2756 |
Eye glass case |
2,905 |
2,667 |
$3K |