| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
6,495 |
6,084 |
$543K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,437 |
3,228 |
$237K |
| V2781 |
Progressive lens, per lens |
1,578 |
1,401 |
$180K |
| V2020 |
Frames, purchases |
10,813 |
9,770 |
$169K |
| V2760 |
Scratch resistant coating, per lens |
9,486 |
8,602 |
$135K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
6,160 |
5,644 |
$104K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
4,317 |
4,070 |
$54K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,778 |
5,140 |
$48K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
802 |
749 |
$14K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
543 |
504 |
$9K |
| V2799 |
Vision item or service, miscellaneous |
651 |
598 |
$6K |
| 92342 |
|
423 |
405 |
$5K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
168 |
145 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
47 |
30 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
19 |
16 |
$747.54 |
| 3072F |
|
129 |
81 |
$570.00 |
| 92250 |
|
33 |
28 |
$297.57 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
202 |
177 |
$70.00 |
| V2756 |
Eye glass case |
202 |
175 |
$0.00 |
| 92015 |
Determination of refractive state |
10,363 |
9,374 |
$0.00 |