| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
576 |
566 |
$26K |
| V2020 |
Frames, purchases |
1,027 |
984 |
$26K |
| 92002 |
|
423 |
415 |
$23K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
66 |
61 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
87 |
81 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
180 |
166 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
88 |
85 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
40 |
39 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
14 |
$502.60 |
| V2756 |
Eye glass case |
482 |
471 |
$498.96 |
| 92015 |
Determination of refractive state |
62 |
61 |
$15.05 |