| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,216 |
3,185 |
$262K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,157 |
3,108 |
$221K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,422 |
3,410 |
$137K |
| V2020 |
Frames, purchases |
4,867 |
4,773 |
$115K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,932 |
4,850 |
$106K |
| V2025 |
Deluxe frame |
1,103 |
1,101 |
$57K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
465 |
464 |
$34K |
| 92015 |
Determination of refractive state |
5,133 |
5,061 |
$26K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,832 |
1,784 |
$20K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
315 |
311 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
43 |
40 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
224 |
219 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
25 |
25 |
$1K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
15 |
13 |
$135.20 |