| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
7,485 |
6,207 |
$772K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,746 |
2,342 |
$342K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,805 |
1,488 |
$85K |
| 92015 |
Determination of refractive state |
10,288 |
8,606 |
$51K |
| V2020 |
Frames, purchases |
8,132 |
6,886 |
$46K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
7,859 |
6,634 |
$20K |
| 68761 |
|
110 |
55 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,577 |
2,986 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,765 |
4,079 |
$7K |
| 92250 |
|
570 |
493 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,678 |
2,212 |
$5K |
| 92020 |
|
390 |
369 |
$1K |
| 2023F |
|
186 |
176 |
$950.00 |
| 92083 |
|
295 |
235 |
$830.98 |
| 92133 |
|
251 |
213 |
$335.36 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
94 |
79 |
$246.60 |
| 92341 |
|
12 |
12 |
$180.00 |
| 76514 |
|
213 |
206 |
$50.65 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
12 |
12 |
$42.50 |
| V2755 |
U-v lens, per lens |
26 |
26 |
$24.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
14 |
14 |
$19.22 |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
26 |
26 |
$6.00 |
| 2022F |
|
144 |
144 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
145 |
145 |
$0.00 |
| 92342 |
|
111 |
111 |
$0.00 |
| V2756 |
Eye glass case |
111 |
111 |
$0.00 |