| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,443 |
4,017 |
$187K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,665 |
2,359 |
$117K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,867 |
1,519 |
$83K |
| 92015 |
Determination of refractive state |
5,360 |
4,946 |
$80K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,855 |
2,621 |
$75K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,348 |
1,145 |
$61K |
| V2020 |
Frames, purchases |
1,691 |
1,667 |
$60K |
| V2025 |
Deluxe frame |
1,483 |
1,176 |
$26K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
917 |
900 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
787 |
772 |
$9K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
86 |
82 |
$6K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
61 |
61 |
$3K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
40 |
40 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
44 |
41 |
$2K |
| 92341 |
|
58 |
51 |
$2K |
| 83861 |
|
38 |
20 |
$590.40 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
39 |
38 |
$357.29 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$261.03 |
| 99072 |
|
19 |
18 |
$20.00 |