| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,692 |
1,576 |
$182K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,790 |
1,683 |
$161K |
| V2020 |
Frames, purchases |
2,848 |
2,663 |
$105K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,345 |
1,247 |
$63K |
| 92015 |
Determination of refractive state |
4,128 |
3,882 |
$61K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
357 |
296 |
$18K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
354 |
332 |
$14K |
| 92250 |
|
52 |
44 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
12 |
$869.26 |