| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
9,976 |
9,952 |
$385K |
| V2020 |
Frames, purchases |
12,739 |
12,710 |
$347K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
8,679 |
8,665 |
$233K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
9,320 |
9,312 |
$121K |
| 92015 |
Determination of refractive state |
18,617 |
18,574 |
$111K |
| V2750 |
Anti-reflective coating, per lens |
930 |
927 |
$110K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,352 |
682 |
$87K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,860 |
940 |
$53K |
| 92341 |
|
1,460 |
1,459 |
$29K |
| 92201 |
|
600 |
598 |
$14K |
| 92250 |
|
209 |
209 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
86 |
43 |
$5K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
23 |
12 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
31 |
31 |
$604.80 |
| V2744 |
Tint, photochromatic, per lens |
24 |
12 |
$449.76 |
| 92225 |
|
16 |
14 |
$180.00 |