| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,668 |
4,216 |
$307K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
1,530 |
1,477 |
$109K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,772 |
1,687 |
$100K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,580 |
2,472 |
$48K |
| V2020 |
Frames, purchases |
4,576 |
4,387 |
$39K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,174 |
4,002 |
$24K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,290 |
1,241 |
$21K |
| 92015 |
Determination of refractive state |
5,443 |
5,214 |
$16K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,811 |
1,752 |
$8K |
| 92250 |
|
371 |
340 |
$6K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
388 |
375 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
101 |
94 |
$5K |
| V2750 |
Anti-reflective coating, per lens |
710 |
691 |
$0.00 |
| 99072 |
|
161 |
158 |
$0.00 |
| S9986 |
Not medically necessary service (patient is aware that service not medically necessary) |
51 |
51 |
$0.00 |