| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,097 |
1,086 |
$53K |
| V2020 |
Frames, purchases |
1,146 |
1,138 |
$36K |
| 92015 |
Determination of refractive state |
1,171 |
1,155 |
$13K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
244 |
244 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
569 |
567 |
$12K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
113 |
113 |
$7K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
99 |
99 |
$5K |
| 92341 |
|
222 |
222 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
358 |
229 |
$3K |
| 92134 |
|
142 |
140 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
31 |
31 |
$1K |
| 92083 |
|
26 |
25 |
$903.38 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
18 |
17 |
$755.93 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
38 |
25 |
$324.66 |
| 92133 |
|
12 |
12 |
$185.38 |
| 92136 |
|
12 |
12 |
$111.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
15 |
12 |
$87.00 |