| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,643 |
3,413 |
$104K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,127 |
946 |
$57K |
| 92250 |
|
2,483 |
1,952 |
$28K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,381 |
2,002 |
$25K |
| 92235 |
|
1,085 |
569 |
$21K |
| 92083 |
|
1,243 |
1,161 |
$21K |
| 92133 |
|
1,792 |
1,673 |
$18K |
| 92134 |
|
2,002 |
1,689 |
$17K |
| 92015 |
Determination of refractive state |
633 |
546 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
661 |
585 |
$15K |
| V2020 |
Frames, purchases |
1,336 |
1,173 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
125 |
104 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
211 |
181 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
194 |
178 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
81 |
72 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
101 |
90 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
103 |
103 |
$854.46 |
| 2022F |
|
451 |
356 |
$110.20 |
| 99072 |
|
30 |
25 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
31 |
25 |
$0.00 |
| 3072F |
|
515 |
514 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
12 |
12 |
$0.00 |
| 3272F |
|
337 |
256 |
$0.00 |
| 1000F |
|
30 |
26 |
$0.00 |
| 1036F |
|
132 |
115 |
$0.00 |