| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
557 |
517 |
$22K |
| V2020 |
Frames, purchases |
667 |
627 |
$13K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
183 |
94 |
$5K |
| 92015 |
Determination of refractive state |
708 |
661 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
124 |
116 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
54 |
51 |
$2K |
| 92250 |
|
171 |
162 |
$2K |
| 92134 |
|
147 |
134 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
24 |
24 |
$677.93 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
56 |
14 |
$426.44 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
48 |
12 |
$268.08 |
| 92133 |
|
14 |
13 |
$146.61 |