| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
6,963 |
6,554 |
$514K |
| V2020 |
Frames, purchases |
7,333 |
6,609 |
$220K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,467 |
1,373 |
$156K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,396 |
2,176 |
$100K |
| 92015 |
Determination of refractive state |
6,732 |
6,345 |
$89K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,836 |
1,702 |
$81K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,345 |
1,247 |
$63K |
| V2755 |
U-v lens, per lens |
2,123 |
2,004 |
$50K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
961 |
810 |
$49K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
248 |
239 |
$23K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
117 |
104 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
50 |
49 |
$4K |
| 99443 |
|
154 |
109 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
29 |
27 |
$1K |
| G8397 |
Dilated macular or fundus exam performed, including documentation of the presence or absence of macular edema and level of severity of retinopathy |
149 |
138 |
$0.00 |
| 0517F |
|
26 |
25 |
$0.00 |
| G2102 |
Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist documented and reviewed |
43 |
43 |
$0.00 |
| 2027F |
|
28 |
26 |
$0.00 |
| 2022F |
|
72 |
68 |
$0.00 |