| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,981 |
1,925 |
$129K |
| 92015 |
Determination of refractive state |
1,401 |
1,382 |
$20K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
255 |
254 |
$12K |
| V2020 |
Frames, purchases |
394 |
371 |
$11K |
| 92002 |
|
25 |
25 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
29 |
26 |
$760.04 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
28 |
14 |
$469.68 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
21 |
14 |
$319.00 |
| V2756 |
Eye glass case |
149 |
148 |
$164.22 |