| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
750 |
735 |
$25K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
571 |
564 |
$24K |
| V2020 |
Frames, purchases |
882 |
859 |
$13K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
174 |
172 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
236 |
233 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
59 |
53 |
$2K |
| 92015 |
Determination of refractive state |
118 |
113 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
27 |
27 |
$525.57 |