| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,031 |
2,031 |
$22K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
336 |
324 |
$13K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
560 |
560 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
440 |
439 |
$8K |
| 92015 |
Determination of refractive state |
538 |
538 |
$2K |
| V2020 |
Frames, purchases |
2,311 |
2,291 |
$980.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,884 |
1,044 |
$630.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
882 |
485 |
$338.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,968 |
1,068 |
$332.50 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
609 |
353 |
$189.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
228 |
228 |
$0.00 |
| V2781 |
Progressive lens, per lens |
287 |
146 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
191 |
97 |
$0.00 |
| V2599 |
Contact lens, other type |
12 |
12 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
30 |
30 |
$0.00 |