| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,729 |
4,729 |
$439K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,543 |
2,543 |
$294K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,261 |
3,203 |
$193K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,952 |
5,949 |
$180K |
| 92250 |
|
4,136 |
4,135 |
$122K |
| 92015 |
Determination of refractive state |
6,510 |
6,510 |
$115K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,100 |
4,099 |
$96K |
| V2020 |
Frames, purchases |
5,839 |
5,835 |
$58K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,957 |
1,956 |
$42K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
314 |
314 |
$24K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
83 |
83 |
$9K |
| 92285 |
|
457 |
457 |
$8K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
230 |
230 |
$5K |
| 92134 |
|
91 |
91 |
$2K |
| 92083 |
|
16 |
16 |
$620.34 |
| 92133 |
|
14 |
14 |
$361.06 |
| 92020 |
|
16 |
16 |
$278.64 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$251.10 |
| 76514 |
|
13 |
13 |
$93.39 |