| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,123 |
1,057 |
$95K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,257 |
1,165 |
$86K |
| V2020 |
Frames, purchases |
5,928 |
5,590 |
$85K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,815 |
3,620 |
$63K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
3,928 |
3,751 |
$51K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,675 |
1,622 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
478 |
458 |
$6K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
93 |
87 |
$5K |
| V2799 |
Vision item or service, miscellaneous |
257 |
240 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
236 |
230 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
32 |
18 |
$1K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
40 |
39 |
$697.41 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
19 |
17 |
$83.06 |
| 92015 |
Determination of refractive state |
2,716 |
2,518 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
526 |
513 |
$0.00 |