| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,928 |
3,904 |
$297K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,506 |
2,494 |
$196K |
| 92250 |
|
4,106 |
4,080 |
$165K |
| V2020 |
Frames, purchases |
5,949 |
5,695 |
$125K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,185 |
2,107 |
$83K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
752 |
699 |
$42K |
| 92015 |
Determination of refractive state |
2,467 |
2,454 |
$42K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,136 |
1,184 |
$40K |
| 92083 |
|
185 |
184 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
8,755 |
4,327 |
$6K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
130 |
68 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
114 |
57 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
13 |
$2K |
| 92133 |
|
53 |
53 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
62 |
37 |
$1K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
13 |
13 |
$520.00 |
| 92273 |
|
12 |
12 |
$516.32 |
| 92370 |
|
28 |
28 |
$196.00 |