| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,582 |
4,408 |
$533K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,578 |
4,453 |
$431K |
| V2020 |
Frames, purchases |
3,931 |
3,511 |
$157K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
1,447 |
1,364 |
$112K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,040 |
1,803 |
$93K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,915 |
3,509 |
$85K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,867 |
3,463 |
$69K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
385 |
347 |
$24K |
| 92250 |
|
374 |
351 |
$15K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
167 |
154 |
$12K |
| 92015 |
Determination of refractive state |
10,152 |
9,740 |
$11K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
188 |
168 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
117 |
101 |
$7K |
| 92083 |
|
84 |
81 |
$4K |
| 92133 |
|
133 |
121 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
57 |
53 |
$3K |
| 92020 |
|
12 |
12 |
$247.94 |