| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,556 |
2,419 |
$136K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
869 |
848 |
$44K |
| V2020 |
Frames, purchases |
321 |
318 |
$16K |
| 92015 |
Determination of refractive state |
2,048 |
1,968 |
$14K |
| 92250 |
|
533 |
497 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
290 |
289 |
$9K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
118 |
96 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
71 |
66 |
$3K |
| V2025 |
Deluxe frame |
54 |
54 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
253 |
252 |
$2K |
| 99199 |
Unlisted special service, procedure or report |
589 |
589 |
$0.00 |