| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,802 |
1,652 |
$98K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
941 |
880 |
$40K |
| V2020 |
Frames, purchases |
1,132 |
1,068 |
$26K |
| 92015 |
Determination of refractive state |
1,883 |
1,701 |
$23K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
462 |
430 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
78 |
71 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
117 |
84 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
39 |
38 |
$920.27 |
| V2756 |
Eye glass case |
215 |
215 |
$228.96 |