| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,001 |
2,927 |
$200K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,396 |
4,244 |
$126K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,982 |
3,838 |
$118K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,048 |
1,016 |
$70K |
| V2020 |
Frames, purchases |
4,086 |
3,931 |
$49K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,414 |
2,329 |
$39K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
544 |
500 |
$31K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
741 |
707 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
286 |
273 |
$11K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
206 |
206 |
$3K |
| 92250 |
|
54 |
53 |
$2K |
| 92015 |
Determination of refractive state |
50 |
50 |
$496.95 |