| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,594 |
3,462 |
$317K |
| V2020 |
Frames, purchases |
5,176 |
4,860 |
$136K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,309 |
1,171 |
$114K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,426 |
4,217 |
$107K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,665 |
1,573 |
$107K |
| 92015 |
Determination of refractive state |
3,917 |
3,651 |
$49K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,523 |
2,335 |
$49K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
632 |
566 |
$34K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,415 |
1,379 |
$30K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
802 |
655 |
$27K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,371 |
3,128 |
$25K |
| 92133 |
|
602 |
537 |
$17K |
| 92341 |
|
496 |
492 |
$13K |
| V2755 |
U-v lens, per lens |
947 |
939 |
$11K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
246 |
231 |
$9K |
| V2760 |
Scratch resistant coating, per lens |
1,924 |
1,860 |
$7K |
| 92250 |
|
99 |
94 |
$4K |
| V2750 |
Anti-reflective coating, per lens |
50 |
50 |
$999.10 |
| 92134 |
|
28 |
25 |
$722.34 |
| 99199 |
Unlisted special service, procedure or report |
25 |
25 |
$0.00 |
| 3072F |
|
40 |
37 |
$0.00 |
| 2023F |
|
104 |
100 |
$0.00 |
| V2799 |
Vision item or service, miscellaneous |
26 |
21 |
$0.00 |