| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,055 |
2,018 |
$139K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,185 |
1,153 |
$107K |
| V2020 |
Frames, purchases |
2,733 |
2,669 |
$88K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,169 |
2,129 |
$70K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,780 |
1,737 |
$41K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,182 |
1,151 |
$9K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
286 |
284 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
189 |
183 |
$4K |
| V2760 |
Scratch resistant coating, per lens |
1,202 |
1,167 |
$2K |
| 92250 |
|
17 |
17 |
$790.86 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15 |
12 |
$596.82 |
| 99199 |
Unlisted special service, procedure or report |
22 |
22 |
$0.00 |