| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,181 |
4,165 |
$53K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,350 |
2,346 |
$25K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
787 |
782 |
$14K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
201 |
172 |
$8K |
| 92015 |
Determination of refractive state |
2,881 |
2,869 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
58 |
54 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,075 |
567 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,989 |
2,456 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,749 |
2,880 |
$0.00 |
| 3072F |
|
468 |
461 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
66 |
66 |
$0.00 |
| V2020 |
Frames, purchases |
4,416 |
4,210 |
$0.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
122 |
122 |
$0.00 |