| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
1,389 |
1,387 |
$61K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,966 |
983 |
$39K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
683 |
682 |
$29K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
431 |
431 |
$17K |
| 92083 |
|
320 |
320 |
$15K |
| 92082 |
|
329 |
328 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
250 |
238 |
$13K |
| V2020 |
Frames, purchases |
1,127 |
1,126 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
184 |
171 |
$7K |
| 92015 |
Determination of refractive state |
1,290 |
1,286 |
$2K |
| 92133 |
|
57 |
57 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,512 |
755 |
$860.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
32 |
31 |
$728.34 |
| V2755 |
U-v lens, per lens |
560 |
280 |
$0.00 |