| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,031 |
952 |
$70K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
373 |
347 |
$31K |
| V2020 |
Frames, purchases |
1,809 |
1,617 |
$25K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,375 |
1,250 |
$24K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,760 |
1,584 |
$22K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
54 |
44 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
51 |
49 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$588.91 |
| 92015 |
Determination of refractive state |
14 |
14 |
$370.50 |