| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
16,352 |
14,316 |
$241K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
6,487 |
6,116 |
$206K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,798 |
3,556 |
$145K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,507 |
1,279 |
$47K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
648 |
612 |
$42K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,308 |
1,288 |
$28K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
169 |
160 |
$15K |
| V2020 |
Frames, purchases |
127 |
126 |
$2K |
| 92341 |
|
83 |
78 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
35 |
34 |
$870.80 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
50 |
49 |
$611.00 |
| 92310 |
|
12 |
12 |
$600.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
17 |
17 |
$432.96 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
12 |
$294.03 |
| 1036F |
|
147 |
135 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
147 |
135 |
$0.00 |