| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,935 |
1,859 |
$201K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,858 |
1,779 |
$162K |
| V2020 |
Frames, purchases |
2,472 |
2,374 |
$96K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,189 |
1,147 |
$70K |
| 92015 |
Determination of refractive state |
3,911 |
3,763 |
$59K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
17 |
12 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$906.02 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
14 |
14 |
$754.60 |