| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
6,652 |
6,594 |
$670K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,242 |
4,204 |
$524K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
6,099 |
6,064 |
$210K |
| V2020 |
Frames, purchases |
5,662 |
5,627 |
$159K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,748 |
4,727 |
$108K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
739 |
737 |
$99K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,197 |
1,191 |
$96K |
| 92015 |
Determination of refractive state |
13,476 |
13,352 |
$85K |
| V2025 |
Deluxe frame |
747 |
746 |
$29K |
| 92250 |
|
363 |
360 |
$22K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,679 |
1,671 |
$14K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
166 |
161 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
84 |
78 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
72 |
72 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
256 |
256 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
16 |
16 |
$2K |
| 92341 |
|
28 |
27 |
$1K |
| 92133 |
|
12 |
12 |
$496.60 |
| 3072F |
|
21 |
20 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
105 |
105 |
$0.00 |