| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,342 |
2,892 |
$194K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
907 |
852 |
$62K |
| V2020 |
Frames, purchases |
2,864 |
2,805 |
$57K |
| 92083 |
|
1,228 |
1,059 |
$44K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,121 |
1,090 |
$36K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,790 |
1,748 |
$34K |
| 92250 |
|
986 |
906 |
$31K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
766 |
749 |
$23K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
246 |
245 |
$17K |
| 92133 |
|
696 |
616 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
544 |
533 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,525 |
1,492 |
$8K |
| V2025 |
Deluxe frame |
385 |
360 |
$8K |
| 92015 |
Determination of refractive state |
388 |
371 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
362 |
344 |
$6K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
166 |
156 |
$6K |
| 76514 |
|
733 |
683 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
60 |
56 |
$2K |
| 92310 |
|
12 |
12 |
$903.36 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
14 |
13 |
$378.91 |
| 2022F |
|
26 |
25 |
$0.00 |
| 2023F |
|
16 |
13 |
$0.00 |