| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
7,102 |
6,331 |
$310K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
7,207 |
6,594 |
$199K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,685 |
3,277 |
$166K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,241 |
3,512 |
$158K |
| 92015 |
Determination of refractive state |
8,463 |
7,851 |
$131K |
| V2020 |
Frames, purchases |
2,952 |
2,754 |
$88K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,350 |
1,136 |
$61K |
| V2025 |
Deluxe frame |
2,728 |
2,148 |
$55K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
427 |
309 |
$38K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
313 |
266 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
906 |
876 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
449 |
437 |
$6K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
142 |
132 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
26 |
26 |
$1K |
| 92250 |
|
12 |
12 |
$532.80 |
| 92341 |
|
12 |
12 |
$337.68 |
| V2750 |
Anti-reflective coating, per lens |
213 |
116 |
$0.00 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
23 |
13 |
$0.00 |