| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,333 |
3,306 |
$150K |
| 92015 |
Determination of refractive state |
4,824 |
4,794 |
$100K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,438 |
3,372 |
$72K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,447 |
1,441 |
$71K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
840 |
827 |
$55K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
561 |
526 |
$24K |
| 92250 |
|
357 |
356 |
$12K |
| 92341 |
|
288 |
278 |
$8K |
| 92083 |
|
148 |
148 |
$4K |
| 92133 |
|
104 |
104 |
$2K |
| 83861 |
|
24 |
12 |
$517.68 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
880 |
866 |
$504.00 |
| V2020 |
Frames, purchases |
3,662 |
3,598 |
$460.00 |
| 92020 |
|
29 |
29 |
$340.48 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,639 |
3,571 |
$132.00 |
| V2781 |
Progressive lens, per lens |
51 |
48 |
$90.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,124 |
2,089 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
101 |
101 |
$0.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
14 |
14 |
$0.00 |