| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,737 |
1,703 |
$128K |
| V2020 |
Frames, purchases |
2,791 |
2,665 |
$40K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
325 |
306 |
$27K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,418 |
1,378 |
$26K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
224 |
213 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
53 |
48 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
24 |
24 |
$463.20 |