| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
2,205 |
2,198 |
$61K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
955 |
840 |
$31K |
| 92082 |
|
1,736 |
1,735 |
$29K |
| 92225 |
|
67 |
67 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,979 |
1,979 |
$52.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
799 |
799 |
$26.00 |
| V2020 |
Frames, purchases |
2,273 |
2,232 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
1,992 |
1,048 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
313 |
165 |
$0.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
206 |
206 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,041 |
1,038 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,961 |
2,033 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,229 |
635 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
84 |
84 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
132 |
66 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
54 |
27 |
$0.00 |