| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,477 |
4,189 |
$368K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,072 |
1,962 |
$143K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,231 |
3,984 |
$124K |
| V2020 |
Frames, purchases |
6,887 |
6,468 |
$102K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,651 |
6,287 |
$80K |
| 92015 |
Determination of refractive state |
7,024 |
6,105 |
$69K |
| V2760 |
Scratch resistant coating, per lens |
3,809 |
2,921 |
$40K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,032 |
967 |
$36K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
574 |
533 |
$16K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
340 |
309 |
$10K |
| V2781 |
Progressive lens, per lens |
93 |
85 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
17 |
14 |
$639.57 |
| 92342 |
|
15 |
15 |
$185.40 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
33 |
33 |
$111.18 |
| 2023F |
|
15 |
15 |
$0.00 |