| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,879 |
1,775 |
$122K |
| V2020 |
Frames, purchases |
2,121 |
1,982 |
$60K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
606 |
577 |
$53K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,612 |
1,511 |
$45K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,150 |
1,081 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
400 |
321 |
$16K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,404 |
1,332 |
$10K |
| 92250 |
|
319 |
259 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
274 |
237 |
$7K |
| 92015 |
Determination of refractive state |
2,424 |
2,309 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
254 |
244 |
$4K |
| 92285 |
|
88 |
71 |
$658.28 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
22 |
12 |
$553.28 |
| 92370 |
|
14 |
14 |
$415.32 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
28 |
26 |
$360.00 |
| 92341 |
|
14 |
13 |
$264.00 |
| V2715 |
Prism, per lens |
72 |
63 |
$0.00 |
| 92314 |
|
13 |
13 |
$0.00 |