| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
944 |
831 |
$122K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
428 |
373 |
$50K |
| V2020 |
Frames, purchases |
1,194 |
1,058 |
$14K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
323 |
303 |
$11K |
| 92015 |
Determination of refractive state |
2,102 |
1,825 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,303 |
1,137 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
13 |
$1K |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$1K |
| V2102 |
Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens |
28 |
25 |
$298.41 |
| 92083 |
|
52 |
26 |
$275.22 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
214 |
178 |
$125.53 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
86 |
83 |
$113.72 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
65 |
59 |
$32.18 |
| 92250 |
|
62 |
45 |
$0.00 |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
12 |
12 |
$0.00 |