| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,931 |
1,742 |
$130K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
624 |
584 |
$34K |
| V2020 |
Frames, purchases |
1,538 |
1,416 |
$26K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,620 |
1,430 |
$16K |
| 92015 |
Determination of refractive state |
2,523 |
2,231 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
21 |
17 |
$670.21 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
12 |
$560.00 |
| V2025 |
Deluxe frame |
327 |
295 |
$541.82 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
978 |
883 |
$515.72 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,510 |
1,328 |
$187.50 |
| V2744 |
Tint, photochromatic, per lens |
120 |
110 |
$55.00 |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
231 |
210 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
227 |
209 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
343 |
329 |
$0.00 |