| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
946 |
844 |
$68K |
| V2020 |
Frames, purchases |
1,324 |
1,134 |
$32K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
299 |
272 |
$27K |
| 92015 |
Determination of refractive state |
1,825 |
1,611 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
150 |
130 |
$6K |
| V2755 |
U-v lens, per lens |
398 |
378 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
70 |
56 |
$3K |
| 92250 |
|
54 |
40 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
38 |
29 |
$499.02 |