| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,776 |
5,360 |
$453K |
| V2020 |
Frames, purchases |
7,998 |
7,356 |
$280K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,567 |
2,417 |
$278K |
| 92015 |
Determination of refractive state |
10,094 |
9,476 |
$142K |
| V2755 |
U-v lens, per lens |
5,262 |
4,879 |
$108K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,964 |
2,008 |
$91K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,345 |
1,151 |
$61K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
43 |
25 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15 |
12 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
42 |
28 |
$937.65 |
| 92250 |
|
15 |
12 |
$367.12 |