| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,098 |
1,952 |
$180K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,006 |
930 |
$104K |
| 92015 |
Determination of refractive state |
4,515 |
4,214 |
$62K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,251 |
1,140 |
$56K |
| V2020 |
Frames, purchases |
2,293 |
2,118 |
$52K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
328 |
284 |
$17K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
36 |
31 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
36 |
29 |
$1K |