| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
957 |
945 |
$68K |
| V2020 |
Frames, purchases |
1,981 |
1,962 |
$66K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
658 |
649 |
$56K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
488 |
403 |
$18K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
333 |
320 |
$13K |
| 92015 |
Determination of refractive state |
2,819 |
2,782 |
$13K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
123 |
80 |
$4K |
| 92250 |
|
89 |
89 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
75 |
75 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
14 |
13 |
$272.16 |