| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
19,394 |
18,869 |
$132K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,228 |
1,992 |
$67K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
9,303 |
9,124 |
$38K |
| 92015 |
Determination of refractive state |
17,724 |
17,221 |
$31K |
| 00142 |
|
540 |
517 |
$16K |
| 92136 |
|
259 |
244 |
$6K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
24 |
24 |
$6K |
| 92083 |
|
157 |
152 |
$3K |
| 92134 |
|
170 |
159 |
$2K |
| 92133 |
|
139 |
129 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
29 |
27 |
$664.23 |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$364.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14 |
12 |
$270.93 |
| 92025 |
|
173 |
172 |
$149.64 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
7,874 |
3,889 |
$34.00 |
| V2020 |
Frames, purchases |
18,985 |
18,748 |
$24.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
710 |
352 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
9,155 |
4,537 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
344 |
169 |
$0.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
971 |
483 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
4,561 |
2,249 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
19,957 |
9,875 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
2,662 |
1,324 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
21,150 |
10,456 |
$0.00 |
| V2299 |
Specialty bifocal (by report) |
3,869 |
1,917 |
$0.00 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
26 |
13 |
$0.00 |
| V2781 |
Progressive lens, per lens |
4,002 |
1,981 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
328 |
162 |
$0.00 |