| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,457 |
1,426 |
$125K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,753 |
1,429 |
$103K |
| 92250 |
|
1,088 |
1,053 |
$58K |
| V2020 |
Frames, purchases |
2,231 |
2,130 |
$56K |
| 92015 |
Determination of refractive state |
3,892 |
3,366 |
$51K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
503 |
475 |
$51K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,318 |
1,258 |
$27K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,842 |
1,768 |
$19K |
| 92083 |
|
310 |
299 |
$13K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
348 |
337 |
$7K |
| 68761 |
|
32 |
13 |
$3K |
| 92285 |
|
128 |
120 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
49 |
48 |
$1K |
| 92025 |
|
30 |
28 |
$853.24 |
| 95930 |
|
15 |
15 |
$696.04 |
| 92133 |
|
25 |
25 |
$631.58 |
| V2799 |
Vision item or service, miscellaneous |
208 |
200 |
$0.00 |