| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,664 |
1,454 |
$75K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,692 |
1,583 |
$73K |
| 92015 |
Determination of refractive state |
3,391 |
3,077 |
$57K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,825 |
1,568 |
$52K |
| V2020 |
Frames, purchases |
1,345 |
1,213 |
$18K |
| V2025 |
Deluxe frame |
496 |
444 |
$13K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,091 |
952 |
$11K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
249 |
176 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
300 |
233 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
944 |
810 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
148 |
117 |
$4K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
24 |
24 |
$1K |
| 92250 |
|
25 |
14 |
$937.22 |
| 92083 |
|
20 |
14 |
$707.64 |
| 92341 |
|
24 |
24 |
$656.61 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
15 |
13 |
$173.09 |