| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,293 |
2,239 |
$136K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
626 |
612 |
$53K |
| V2020 |
Frames, purchases |
2,082 |
1,972 |
$51K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
464 |
453 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
451 |
425 |
$9K |
| 92370 |
|
211 |
205 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
82 |
76 |
$2K |
| 92250 |
|
44 |
44 |
$2K |
| V2756 |
Eye glass case |
1,202 |
1,147 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
12 |
12 |
$24.00 |
| 92015 |
Determination of refractive state |
12 |
12 |
$0.00 |