| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,264 |
2,139 |
$56K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,358 |
1,096 |
$37K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,162 |
1,078 |
$18K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
593 |
567 |
$13K |
| 92015 |
Determination of refractive state |
1,176 |
1,092 |
$4K |
| 92250 |
|
84 |
77 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
25 |
24 |
$772.58 |
| V2020 |
Frames, purchases |
1,256 |
1,183 |
$140.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
592 |
309 |
$105.00 |
| 92065 |
|
14 |
12 |
$95.60 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
607 |
315 |
$57.00 |
| V2750 |
Anti-reflective coating, per lens |
129 |
60 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
554 |
261 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
14 |
12 |
$0.00 |