| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,939 |
2,794 |
$203K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,346 |
1,285 |
$108K |
| V2020 |
Frames, purchases |
5,969 |
5,479 |
$88K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
5,000 |
4,704 |
$63K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,335 |
3,101 |
$51K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
512 |
460 |
$26K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,453 |
1,366 |
$20K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
448 |
420 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
167 |
117 |
$6K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
165 |
150 |
$3K |
| 3072F |
|
19 |
12 |
$0.00 |
| 92015 |
Determination of refractive state |
3,324 |
3,077 |
$0.00 |