| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,113 |
2,113 |
$230K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
803 |
803 |
$105K |
| 92250 |
|
2,472 |
2,472 |
$77K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,535 |
2,531 |
$77K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,037 |
981 |
$72K |
| 92015 |
Determination of refractive state |
3,600 |
3,600 |
$63K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,921 |
1,909 |
$47K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
508 |
508 |
$44K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
485 |
483 |
$38K |
| 92082 |
|
932 |
932 |
$36K |
| V2020 |
Frames, purchases |
2,856 |
2,853 |
$28K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
766 |
761 |
$18K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
399 |
396 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
48 |
48 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
15 |
$2K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
13 |
13 |
$292.95 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,081 |
3,061 |
$0.00 |