| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
8,163 |
8,161 |
$885K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,601 |
3,601 |
$465K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
11,983 |
11,923 |
$362K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,262 |
3,192 |
$361K |
| 92015 |
Determination of refractive state |
15,593 |
15,559 |
$275K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,339 |
1,339 |
$195K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
6,852 |
6,771 |
$181K |
| V2020 |
Frames, purchases |
12,758 |
12,673 |
$127K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,003 |
4,940 |
$114K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,363 |
1,293 |
$104K |
| 92370 |
|
2,945 |
2,898 |
$80K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
2,637 |
2,605 |
$57K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
137 |
136 |
$10K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
373 |
371 |
$8K |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
262 |
261 |
$5K |
| 99222 |
Initial hospital care, per day, moderate complexity |
12 |
12 |
$1K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
26 |
26 |
$502.20 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
937 |
928 |
$0.00 |