| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,142 |
4,723 |
$439K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,553 |
3,273 |
$368K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
2,439 |
1,908 |
$335K |
| V2025 |
Deluxe frame |
2,852 |
2,278 |
$279K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,037 |
2,327 |
$119K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,734 |
4,449 |
$95K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,549 |
4,300 |
$95K |
| V2020 |
Frames, purchases |
2,748 |
2,238 |
$92K |
| V2750 |
Anti-reflective coating, per lens |
3,562 |
2,714 |
$54K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,048 |
846 |
$33K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
512 |
438 |
$26K |
| 92015 |
Determination of refractive state |
8,865 |
8,110 |
$10K |
| V2744 |
Tint, photochromatic, per lens |
507 |
473 |
$5K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
102 |
81 |
$4K |
| 92310 |
|
117 |
104 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
74 |
50 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
12 |
$993.15 |