| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,319 |
1,296 |
$50K |
| 92015 |
Determination of refractive state |
4,329 |
4,273 |
$48K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,718 |
1,691 |
$48K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,704 |
1,676 |
$36K |
| 92341 |
|
1,223 |
1,198 |
$28K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
502 |
495 |
$19K |
| V2020 |
Frames, purchases |
295 |
294 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
571 |
555 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
53 |
52 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
29 |
28 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
46 |
46 |
$853.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
54 |
54 |
$583.00 |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
119 |
108 |
$540.54 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
75 |
75 |
$265.00 |
| 92133 |
|
15 |
15 |
$239.40 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15 |
15 |
$22.20 |
| 3072F |
|
13 |
13 |
$0.00 |