| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,161 |
1,105 |
$78K |
| V2020 |
Frames, purchases |
1,612 |
1,501 |
$42K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
412 |
394 |
$37K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
923 |
870 |
$27K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
555 |
513 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
755 |
703 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
131 |
115 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
136 |
126 |
$2K |
| 92015 |
Determination of refractive state |
1,079 |
1,025 |
$2K |
| 92133 |
|
60 |
55 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$650.19 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
17 |
12 |
$413.03 |
| 92341 |
|
14 |
12 |
$396.00 |
| 92370 |
|
12 |
12 |
$362.50 |