| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,030 |
2,023 |
$113K |
| 92250 |
|
1,725 |
1,719 |
$71K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
822 |
818 |
$56K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,001 |
1,508 |
$49K |
| V2020 |
Frames, purchases |
2,579 |
2,557 |
$28K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
743 |
709 |
$27K |
| 92202 |
|
348 |
347 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
319 |
166 |
$3K |
| 92285 |
|
70 |
70 |
$2K |
| 92225 |
|
68 |
67 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
51 |
26 |
$1K |
| 92015 |
Determination of refractive state |
577 |
564 |
$816.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
29 |
29 |
$378.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,461 |
1,228 |
$282.40 |
| 2023F |
|
14 |
14 |
$0.00 |
| V2755 |
U-v lens, per lens |
50 |
25 |
$0.00 |
| 92310 |
|
13 |
13 |
$0.00 |