| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,717 |
2,600 |
$191K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,706 |
1,631 |
$148K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,634 |
1,360 |
$71K |
| V2020 |
Frames, purchases |
3,429 |
3,216 |
$50K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,637 |
1,519 |
$44K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,298 |
1,225 |
$35K |
| 92015 |
Determination of refractive state |
2,561 |
2,407 |
$21K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,878 |
1,685 |
$20K |
| 92250 |
|
423 |
403 |
$17K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
245 |
191 |
$6K |
| 92002 |
|
79 |
79 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
209 |
198 |
$2K |
| 92083 |
|
25 |
25 |
$1K |
| 92285 |
|
48 |
39 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
15 |
$877.10 |
| V2799 |
Vision item or service, miscellaneous |
35 |
35 |
$435.32 |
| 99199 |
Unlisted special service, procedure or report |
14 |
14 |
$0.00 |
| 2023F |
|
115 |
114 |
$0.00 |
| 3072F |
|
198 |
170 |
$0.00 |