| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,626 |
4,593 |
$459K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,866 |
3,936 |
$191K |
| V2020 |
Frames, purchases |
5,812 |
5,724 |
$166K |
| 92083 |
|
2,677 |
2,672 |
$144K |
| 76512 |
|
2,235 |
1,130 |
$125K |
| 92250 |
|
2,535 |
2,516 |
$106K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,012 |
1,012 |
$104K |
| 92285 |
|
3,061 |
3,044 |
$70K |
| 92015 |
Determination of refractive state |
2,952 |
2,946 |
$54K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
686 |
466 |
$25K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
598 |
452 |
$24K |
| 92082 |
|
428 |
426 |
$20K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
282 |
275 |
$16K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
95 |
95 |
$8K |
| 76514 |
|
546 |
544 |
$5K |
| 92020 |
|
257 |
254 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
217 |
216 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,750 |
1,964 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
40 |
40 |
$2K |
| 92341 |
|
37 |
37 |
$690.00 |
| 92133 |
|
12 |
12 |
$374.94 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$303.43 |
| 3072F |
|
12 |
12 |
$0.00 |