| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,459 |
1,153 |
$65K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
726 |
583 |
$35K |
| 92015 |
Determination of refractive state |
1,816 |
1,650 |
$30K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
928 |
807 |
$27K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
509 |
312 |
$25K |
| 83861 |
|
1,072 |
560 |
$23K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
390 |
330 |
$10K |
| 92250 |
|
214 |
172 |
$9K |
| V2025 |
Deluxe frame |
388 |
265 |
$8K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
200 |
191 |
$4K |
| V2020 |
Frames, purchases |
248 |
169 |
$4K |
| 92002 |
|
39 |
35 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
124 |
124 |
$942.22 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
20 |
14 |
$859.07 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
54 |
54 |
$732.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
16 |
16 |
$368.00 |
| 76514 |
|
48 |
43 |
$289.15 |
| V2750 |
Anti-reflective coating, per lens |
24 |
12 |
$0.00 |