| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,219 |
3,091 |
$206K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,029 |
1,974 |
$180K |
| V2020 |
Frames, purchases |
4,041 |
3,841 |
$106K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,012 |
1,799 |
$38K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
298 |
260 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
588 |
568 |
$12K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
115 |
109 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
897 |
854 |
$3K |
| V2756 |
Eye glass case |
2,644 |
2,540 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
73 |
68 |
$1K |
| 92083 |
|
12 |
12 |
$631.92 |
| 92285 |
|
15 |
12 |
$582.66 |
| 92015 |
Determination of refractive state |
5,105 |
4,911 |
$30.10 |
| V2750 |
Anti-reflective coating, per lens |
72 |
72 |
$0.00 |