| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,431 |
5,059 |
$230K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,381 |
3,161 |
$151K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,838 |
4,616 |
$140K |
| 92015 |
Determination of refractive state |
7,782 |
7,495 |
$132K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,242 |
2,832 |
$99K |
| V2020 |
Frames, purchases |
2,972 |
2,782 |
$50K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
745 |
622 |
$40K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
779 |
640 |
$35K |
| V2025 |
Deluxe frame |
1,613 |
1,275 |
$30K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,196 |
1,138 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
51 |
31 |
$1K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
15 |
15 |
$666.75 |
| 3072F |
|
246 |
244 |
$0.00 |
| 2023F |
|
75 |
73 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
63 |
54 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
22 |
13 |
$0.00 |