| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,044 |
3,783 |
$209K |
| 92015 |
Determination of refractive state |
6,465 |
6,041 |
$184K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,734 |
4,524 |
$137K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,078 |
1,945 |
$66K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
628 |
578 |
$44K |
| V2020 |
Frames, purchases |
3,197 |
2,979 |
$38K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,343 |
1,015 |
$23K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
500 |
459 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
177 |
158 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
337 |
316 |
$5K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
59 |
55 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
16 |
12 |
$586.51 |
| 92250 |
|
17 |
12 |
$152.43 |
| 2022F |
|
15 |
12 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
12 |
12 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
13 |
12 |
$0.00 |