| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
11,327 |
11,292 |
$284K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,603 |
5,543 |
$102K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
689 |
644 |
$27K |
| 92015 |
Determination of refractive state |
6,068 |
6,043 |
$24K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
463 |
456 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
6,397 |
3,316 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
129 |
124 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
842 |
465 |
$2K |
| V2020 |
Frames, purchases |
5,507 |
5,465 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,576 |
2,864 |
$2K |
| 92133 |
|
71 |
71 |
$2K |
| V2299 |
Specialty bifocal (by report) |
426 |
212 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,544 |
804 |
$0.00 |
| 2023F |
|
1,617 |
1,605 |
$0.00 |
| V2799 |
Vision item or service, miscellaneous |
56 |
27 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
403 |
205 |
$0.00 |
| V2781 |
Progressive lens, per lens |
535 |
274 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
37 |
37 |
$0.00 |
| 3072F |
|
35 |
34 |
$0.00 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
44 |
21 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
24 |
12 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
335 |
184 |
$0.00 |
| 2022F |
|
180 |
174 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
24 |
12 |
$0.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
112 |
112 |
$0.00 |