| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,138 |
2,422 |
$110K |
| 92082 |
|
2,630 |
2,253 |
$71K |
| 92250 |
|
1,090 |
1,067 |
$38K |
| V2020 |
Frames, purchases |
358 |
335 |
$13K |
| 92134 |
|
189 |
187 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
248 |
229 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
49 |
46 |
$3K |
| 92015 |
Determination of refractive state |
376 |
367 |
$2K |
| 92133 |
|
55 |
54 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
81 |
80 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
42 |
39 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
25 |
25 |
$1K |
| V2756 |
Eye glass case |
359 |
336 |
$249.30 |
| S9999 |
Sales tax |
4,468 |
2,900 |
$0.00 |