| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,307 |
2,300 |
$103K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,042 |
1,037 |
$62K |
| 92250 |
|
1,305 |
1,298 |
$59K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,182 |
1,575 |
$46K |
| V2020 |
Frames, purchases |
2,045 |
2,015 |
$26K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
291 |
280 |
$11K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
382 |
189 |
$9K |
| 92202 |
|
104 |
104 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
111 |
111 |
$2K |
| 92083 |
|
13 |
13 |
$604.50 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
98 |
54 |
$582.06 |
| 92133 |
|
12 |
12 |
$360.24 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,312 |
1,134 |
$170.00 |
| 92015 |
Determination of refractive state |
452 |
451 |
$91.20 |