| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,013 |
1,952 |
$172K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,082 |
2,021 |
$156K |
| V2020 |
Frames, purchases |
2,599 |
2,542 |
$129K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,458 |
1,424 |
$50K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,463 |
1,422 |
$40K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
898 |
892 |
$33K |
| 92015 |
Determination of refractive state |
3,334 |
3,237 |
$31K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
404 |
400 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
237 |
230 |
$7K |
| 92133 |
|
14 |
14 |
$319.03 |