| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,301 |
4,859 |
$354K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,466 |
2,291 |
$209K |
| V2020 |
Frames, purchases |
7,285 |
6,545 |
$103K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
5,580 |
5,192 |
$69K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,768 |
2,504 |
$46K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,497 |
2,152 |
$37K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
527 |
434 |
$20K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
324 |
279 |
$17K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
300 |
244 |
$15K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,202 |
1,104 |
$13K |
| 92250 |
|
283 |
184 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
161 |
94 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
166 |
140 |
$2K |
| 92134 |
|
143 |
114 |
$2K |
| 92133 |
|
17 |
12 |
$235.55 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
15 |
13 |
$221.40 |
| V2799 |
Vision item or service, miscellaneous |
14 |
12 |
$148.89 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
45 |
40 |
$41.53 |
| 92015 |
Determination of refractive state |
7,593 |
6,701 |
$0.00 |