| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,956 |
1,914 |
$79K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,161 |
3,017 |
$61K |
| 92015 |
Determination of refractive state |
3,523 |
3,399 |
$60K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
887 |
861 |
$37K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
728 |
695 |
$29K |
| V2020 |
Frames, purchases |
3,988 |
3,850 |
$26K |
| 92341 |
|
554 |
521 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
700 |
680 |
$12K |
| 92250 |
|
594 |
565 |
$11K |
| V2760 |
Scratch resistant coating, per lens |
1,054 |
1,020 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,927 |
3,779 |
$8K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,915 |
1,841 |
$8K |
| V2755 |
U-v lens, per lens |
1,055 |
1,021 |
$6K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
191 |
182 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
12 |
12 |
$374.10 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$173.28 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
17 |
14 |
$21.00 |
| 1036F |
|
422 |
411 |
$0.00 |
| 2026F |
|
144 |
137 |
$0.00 |
| 2022F |
|
72 |
69 |
$0.00 |
| 5010F |
|
99 |
91 |
$0.00 |
| 4004F |
|
33 |
26 |
$0.00 |