| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,167 |
1,056 |
$95K |
| V2020 |
Frames, purchases |
1,415 |
1,298 |
$58K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
555 |
510 |
$55K |
| 92015 |
Determination of refractive state |
2,338 |
2,131 |
$29K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
345 |
179 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
203 |
192 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
67 |
65 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15 |
12 |
$527.40 |