| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
199 |
175 |
$12K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
117 |
107 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
547 |
429 |
$8K |
| 83861 |
|
362 |
159 |
$7K |
| V2020 |
Frames, purchases |
303 |
275 |
$6K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
143 |
119 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
113 |
104 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
84 |
72 |
$4K |
| 92015 |
Determination of refractive state |
278 |
243 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
37 |
32 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
44 |
39 |
$2K |
| 92250 |
|
53 |
50 |
$2K |
| 92341 |
|
56 |
42 |
$873.24 |
| 92370 |
|
31 |
30 |
$536.33 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
24 |
24 |
$276.08 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
80 |
55 |
$52.80 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
17 |
12 |
$40.38 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
21 |
15 |
$0.00 |