| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,147 |
3,992 |
$275K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,870 |
1,807 |
$164K |
| V2020 |
Frames, purchases |
4,828 |
4,569 |
$135K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,989 |
3,819 |
$113K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,653 |
2,522 |
$44K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,731 |
1,629 |
$28K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,909 |
2,790 |
$21K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
446 |
347 |
$15K |
| 92015 |
Determination of refractive state |
4,450 |
4,295 |
$13K |
| 92250 |
|
60 |
53 |
$2K |
| V2781 |
Progressive lens, per lens |
16 |
14 |
$560.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15 |
13 |
$479.50 |
| 92370 |
|
13 |
12 |
$348.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
13 |
13 |
$170.00 |