| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,687 |
4,050 |
$401K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,463 |
2,141 |
$258K |
| V2020 |
Frames, purchases |
5,351 |
4,468 |
$218K |
| 92015 |
Determination of refractive state |
7,654 |
6,722 |
$100K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,841 |
996 |
$60K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,941 |
1,735 |
$49K |
| V2755 |
U-v lens, per lens |
80 |
67 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
37 |
37 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15 |
12 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
43 |
38 |
$559.52 |
| 92250 |
|
31 |
30 |
$486.60 |