| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
17,675 |
16,171 |
$1.49M |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
10,495 |
9,446 |
$1.04M |
| V2020 |
Frames, purchases |
20,884 |
19,343 |
$679K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15,064 |
9,057 |
$440K |
| 92015 |
Determination of refractive state |
31,424 |
28,419 |
$410K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,634 |
3,525 |
$120K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
698 |
442 |
$18K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,148 |
1,056 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
145 |
129 |
$8K |
| 92250 |
|
137 |
116 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
91 |
70 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16 |
15 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
26 |
24 |
$802.16 |
| V2750 |
Anti-reflective coating, per lens |
13 |
13 |
$21.00 |