| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
22,090 |
22,025 |
$1.91M |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
13,836 |
13,800 |
$955K |
| 92015 |
Determination of refractive state |
40,615 |
40,476 |
$527K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
27,406 |
27,264 |
$493K |
| V2020 |
Frames, purchases |
3,643 |
3,635 |
$72K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,385 |
1,385 |
$68K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,772 |
1,758 |
$63K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,339 |
2,334 |
$40K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
549 |
547 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
172 |
165 |
$8K |
| 92002 |
|
155 |
155 |
$7K |
| 92250 |
|
231 |
230 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
338 |
333 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
16 |
16 |
$969.06 |
| V2025 |
Deluxe frame |
12 |
12 |
$819.00 |
| 92083 |
|
12 |
12 |
$379.96 |