| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,571 |
1,380 |
$100K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,031 |
925 |
$83K |
| V2020 |
Frames, purchases |
2,652 |
2,265 |
$33K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,191 |
1,065 |
$20K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,510 |
1,346 |
$17K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
551 |
513 |
$10K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
63 |
59 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
50 |
39 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
18 |
17 |
$482.02 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$212.30 |
| 92015 |
Determination of refractive state |
15 |
15 |
$0.00 |
| 99072 |
|
209 |
194 |
$0.00 |