| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
418 |
389 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
285 |
265 |
$5K |
| 92015 |
Determination of refractive state |
861 |
797 |
$5K |
| V2020 |
Frames, purchases |
92 |
83 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
135 |
129 |
$4K |
| V2025 |
Deluxe frame |
383 |
367 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
14 |
$989.38 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
87 |
81 |
$942.50 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
30 |
26 |
$621.46 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
231 |
224 |
$591.16 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
21 |
12 |
$436.92 |
| 92134 |
|
12 |
12 |
$331.75 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18 |
13 |
$253.48 |
| V2756 |
Eye glass case |
82 |
70 |
$113.91 |