| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,720 |
4,439 |
$206K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,445 |
4,043 |
$201K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,552 |
5,254 |
$155K |
| 92015 |
Determination of refractive state |
8,728 |
8,241 |
$146K |
| V2025 |
Deluxe frame |
2,882 |
2,513 |
$76K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,105 |
908 |
$48K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
710 |
623 |
$32K |
| V2020 |
Frames, purchases |
763 |
758 |
$23K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
134 |
133 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
778 |
765 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
486 |
479 |
$4K |
| 92341 |
|
112 |
97 |
$3K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
34 |
33 |
$2K |
| 92002 |
|
43 |
39 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
15 |
$982.10 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
60 |
59 |
$279.74 |
| 3072F |
|
111 |
111 |
$0.00 |
| 2023F |
|
105 |
104 |
$0.00 |