| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,445 |
1,434 |
$125K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,003 |
990 |
$103K |
| V2020 |
Frames, purchases |
3,114 |
2,954 |
$63K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,914 |
1,823 |
$43K |
| 92015 |
Determination of refractive state |
3,115 |
3,084 |
$40K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
598 |
586 |
$34K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
464 |
458 |
$28K |
| 92025 |
|
348 |
347 |
$9K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
390 |
348 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
351 |
324 |
$7K |
| V2750 |
Anti-reflective coating, per lens |
77 |
77 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
90 |
81 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
36 |
35 |
$1K |
| 92310 |
|
15 |
14 |
$140.30 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
36 |
36 |
$0.00 |