| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
12,820 |
11,901 |
$1.19M |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
6,330 |
6,203 |
$558K |
| 92250 |
|
7,736 |
6,890 |
$384K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,081 |
1,958 |
$303K |
| V2020 |
Frames, purchases |
13,070 |
12,891 |
$274K |
| 92015 |
Determination of refractive state |
15,220 |
13,897 |
$239K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
12,823 |
12,734 |
$216K |
| 92025 |
|
4,689 |
4,399 |
$143K |
| 92273 |
|
1,113 |
1,033 |
$125K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,239 |
4,166 |
$103K |
| 92083 |
|
1,794 |
1,725 |
$98K |
| 92133 |
|
1,969 |
1,828 |
$74K |
| 92283 |
|
1,292 |
1,249 |
$60K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
7,176 |
7,119 |
$60K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,332 |
5,285 |
$49K |
| V2760 |
Scratch resistant coating, per lens |
2,365 |
2,339 |
$40K |
| 92285 |
|
2,475 |
2,237 |
$40K |
| V2025 |
Deluxe frame |
1,045 |
1,044 |
$38K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
324 |
297 |
$31K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,014 |
999 |
$29K |
| 92020 |
|
1,785 |
1,369 |
$29K |
| 92275 |
|
171 |
171 |
$24K |
| A4556 |
Electrodes, (e.g., apnea monitor), per pair |
1,597 |
1,496 |
$22K |
| 76514 |
|
1,390 |
1,367 |
$20K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
518 |
505 |
$19K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
2,313 |
2,296 |
$15K |
| V2755 |
U-v lens, per lens |
424 |
414 |
$9K |
| 0509T |
|
148 |
146 |
$7K |
| A4558 |
Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz |
1,597 |
1,496 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
35 |
35 |
$3K |
| 92341 |
|
68 |
68 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
22 |
21 |
$1K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
85 |
84 |
$1K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
145 |
141 |
$840.40 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
16 |
16 |
$415.08 |
| V2750 |
Anti-reflective coating, per lens |
810 |
800 |
$240.00 |
| 99199 |
Unlisted special service, procedure or report |
161 |
161 |
$0.00 |
| 99072 |
|
2,182 |
2,074 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
760 |
757 |
$0.00 |