| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,250 |
2,193 |
$174K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,423 |
2,360 |
$154K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,496 |
1,458 |
$136K |
| V2025 |
Deluxe frame |
1,104 |
1,077 |
$54K |
| 92015 |
Determination of refractive state |
3,605 |
3,517 |
$44K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,064 |
1,033 |
$20K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
562 |
551 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
196 |
184 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
191 |
189 |
$3K |
| 92250 |
|
166 |
164 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17 |
16 |
$2K |
| 92341 |
|
59 |
54 |
$1K |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
17 |
16 |
$989.38 |
| 92083 |
|
12 |
12 |
$278.34 |
| 92133 |
|
12 |
12 |
$190.26 |
| V2760 |
Scratch resistant coating, per lens |
41 |
41 |
$12.82 |
| S9986 |
Not medically necessary service (patient is aware that service not medically necessary) |
17 |
17 |
$0.00 |