| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
614 |
571 |
$63K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
744 |
673 |
$58K |
| V2020 |
Frames, purchases |
1,153 |
1,061 |
$44K |
| 92015 |
Determination of refractive state |
3,402 |
3,000 |
$43K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
396 |
335 |
$16K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
211 |
188 |
$10K |
| 92002 |
|
159 |
142 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
180 |
169 |
$7K |
| V2755 |
U-v lens, per lens |
237 |
235 |
$5K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
33 |
31 |
$2K |