| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,451 |
5,442 |
$33K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
548 |
537 |
$20K |
| 99215 |
Prolong outpt/office vis |
145 |
145 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
510 |
507 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
244 |
235 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
637 |
637 |
$5K |
| 92015 |
Determination of refractive state |
2,997 |
2,992 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
16 |
16 |
$419.20 |
| 92083 |
|
12 |
12 |
$192.00 |
| V2020 |
Frames, purchases |
4,414 |
4,363 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
181 |
97 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
276 |
134 |
$0.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
134 |
134 |
$0.00 |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
12 |
12 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,684 |
2,322 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,541 |
1,777 |
$0.00 |
| V2599 |
Contact lens, other type |
29 |
29 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,138 |
597 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
232 |
115 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
117 |
65 |
$0.00 |