| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
9,089 |
8,868 |
$193K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,785 |
3,764 |
$171K |
| 92015 |
Determination of refractive state |
5,394 |
5,368 |
$112K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,613 |
1,608 |
$79K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
812 |
790 |
$53K |
| 92341 |
|
1,176 |
1,149 |
$31K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
193 |
180 |
$8K |
| 92250 |
|
149 |
149 |
$5K |
| 92083 |
|
71 |
71 |
$2K |
| 92133 |
|
91 |
85 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,193 |
2,151 |
$1K |
| V2020 |
Frames, purchases |
9,653 |
9,443 |
$937.00 |
| 92020 |
|
33 |
33 |
$413.44 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
9,740 |
9,513 |
$297.77 |
| 83861 |
|
32 |
14 |
$43.14 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
877 |
856 |
$37.70 |
| V2781 |
Progressive lens, per lens |
35 |
34 |
$20.00 |
| 83516 |
|
39 |
14 |
$10.68 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
6,004 |
5,866 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,023 |
997 |
$0.00 |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
13 |
12 |
$0.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
692 |
674 |
$0.00 |
| V2025 |
Deluxe frame |
45 |
45 |
$0.00 |