| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
904 |
879 |
$83K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,203 |
1,077 |
$62K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,245 |
1,219 |
$51K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,153 |
1,140 |
$48K |
| 92273 |
|
554 |
533 |
$44K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
542 |
514 |
$43K |
| V2025 |
Deluxe frame |
2,312 |
2,122 |
$39K |
| 92083 |
|
966 |
914 |
$38K |
| 92250 |
|
672 |
645 |
$35K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,638 |
1,860 |
$25K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
853 |
794 |
$22K |
| 92133 |
|
676 |
642 |
$17K |
| 92015 |
Determination of refractive state |
1,543 |
1,482 |
$17K |
| V2020 |
Frames, purchases |
1,452 |
1,212 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,249 |
703 |
$9K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
504 |
293 |
$3K |
| 92020 |
|
226 |
224 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
16 |
13 |
$646.52 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
126 |
59 |
$580.00 |
| 92285 |
|
26 |
26 |
$215.55 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
26 |
13 |
$197.22 |