| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,389 |
2,104 |
$192K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,112 |
1,020 |
$111K |
| V2020 |
Frames, purchases |
2,871 |
2,551 |
$99K |
| 92015 |
Determination of refractive state |
4,822 |
4,269 |
$64K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
378 |
358 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
210 |
193 |
$10K |
| V2755 |
U-v lens, per lens |
411 |
365 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18 |
13 |
$998.82 |