| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,761 |
1,736 |
$157K |
| V2020 |
Frames, purchases |
6,946 |
6,708 |
$146K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
947 |
936 |
$99K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,146 |
4,014 |
$91K |
| 92015 |
Determination of refractive state |
3,595 |
3,551 |
$49K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
589 |
584 |
$36K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,161 |
1,126 |
$24K |
| V2750 |
Anti-reflective coating, per lens |
520 |
507 |
$18K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
836 |
817 |
$16K |
| 92025 |
|
434 |
431 |
$12K |
| 92250 |
|
205 |
202 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
306 |
298 |
$9K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
145 |
140 |
$8K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
226 |
221 |
$4K |
| 92310 |
|
40 |
40 |
$3K |
| 92002 |
|
25 |
25 |
$1K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
37 |
37 |
$758.40 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
115 |
112 |
$719.10 |
| 92285 |
|
52 |
51 |
$608.94 |
| 92286 |
|
12 |
12 |
$314.70 |