| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
5,078 |
4,841 |
$396K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,716 |
4,578 |
$284K |
| V2750 |
Anti-reflective coating, per lens |
2,604 |
2,501 |
$228K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
9,380 |
9,035 |
$159K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
1,608 |
1,562 |
$151K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
7,188 |
6,897 |
$113K |
| 92015 |
Determination of refractive state |
9,450 |
9,077 |
$79K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,712 |
5,499 |
$73K |
| V2020 |
Frames, purchases |
7,172 |
6,882 |
$54K |
| V2499 |
Variable sphericity lens, other type |
571 |
545 |
$37K |
| V2755 |
U-v lens, per lens |
904 |
866 |
$22K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
455 |
435 |
$9K |
| 92341 |
|
421 |
399 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
355 |
345 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
93 |
78 |
$3K |
| 92250 |
|
30 |
30 |
$1K |
| 92134 |
|
40 |
39 |
$1K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
42 |
41 |
$1K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
25 |
25 |
$914.00 |