| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,105 |
1,859 |
$170K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,238 |
1,919 |
$129K |
| V2020 |
Frames, purchases |
2,808 |
2,316 |
$58K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,336 |
1,941 |
$46K |
| 92015 |
Determination of refractive state |
1,138 |
1,067 |
$15K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
176 |
138 |
$6K |
| V2756 |
Eye glass case |
2,277 |
1,853 |
$2K |
| 92083 |
|
39 |
26 |
$1K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
42 |
28 |
$922.42 |