| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,040 |
860 |
$66K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
607 |
516 |
$49K |
| V2020 |
Frames, purchases |
1,694 |
1,356 |
$20K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,632 |
1,351 |
$16K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,145 |
889 |
$15K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
250 |
189 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
40 |
29 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
83 |
68 |
$1K |
| 92250 |
|
20 |
20 |
$875.67 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13 |
12 |
$589.75 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
24 |
12 |
$210.49 |
| 92015 |
Determination of refractive state |
1,681 |
1,372 |
$0.00 |