| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,641 |
2,547 |
$105K |
| 92250 |
|
3,015 |
2,853 |
$100K |
| V2020 |
Frames, purchases |
1,664 |
1,523 |
$91K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,501 |
1,379 |
$65K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
840 |
797 |
$43K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
793 |
743 |
$39K |
| 92015 |
Determination of refractive state |
3,786 |
3,620 |
$31K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,478 |
1,357 |
$26K |
| 92134 |
|
507 |
477 |
$15K |
| 95930 |
|
274 |
265 |
$13K |
| 92273 |
|
74 |
64 |
$4K |
| 92225 |
|
388 |
208 |
$4K |
| V2756 |
Eye glass case |
2,176 |
1,979 |
$2K |
| 92275 |
|
41 |
39 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
74 |
64 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
25 |
20 |
$2K |
| 92284 |
|
34 |
32 |
$2K |
| V2025 |
Deluxe frame |
99 |
84 |
$2K |
| 92202 |
|
129 |
124 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15 |
13 |
$511.42 |
| 92083 |
|
12 |
12 |
$504.31 |
| 92341 |
|
19 |
16 |
$499.35 |
| 92133 |
|
12 |
12 |
$439.98 |
| 92285 |
|
16 |
15 |
$223.22 |
| V2750 |
Anti-reflective coating, per lens |
48 |
42 |
$62.63 |
| 99072 |
|
24 |
24 |
$0.00 |