| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,669 |
5,292 |
$346K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,129 |
2,016 |
$181K |
| V2020 |
Frames, purchases |
5,953 |
5,593 |
$172K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,253 |
4,916 |
$146K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,170 |
2,700 |
$49K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,102 |
4,751 |
$37K |
| 92015 |
Determination of refractive state |
8,860 |
8,205 |
$24K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
555 |
486 |
$8K |
| V2760 |
Scratch resistant coating, per lens |
3,257 |
2,958 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
83 |
79 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
214 |
185 |
$3K |
| 92370 |
|
105 |
96 |
$3K |
| V2750 |
Anti-reflective coating, per lens |
112 |
112 |
$1K |
| 92341 |
|
12 |
12 |
$396.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$209.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
14 |
12 |
$177.00 |