| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,810 |
2,810 |
$119K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,356 |
1,355 |
$25K |
| 92341 |
|
564 |
563 |
$11K |
| 92015 |
Determination of refractive state |
2,284 |
2,282 |
$10K |
| 92133 |
|
276 |
272 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
136 |
135 |
$5K |
| 76514 |
|
42 |
42 |
$910.00 |
| 92083 |
|
38 |
38 |
$742.40 |
| V2020 |
Frames, purchases |
828 |
805 |
$496.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
310 |
192 |
$235.20 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
564 |
330 |
$119.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
346 |
346 |
$52.80 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
592 |
336 |
$40.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
265 |
150 |
$27.00 |
| V2599 |
Contact lens, other type |
74 |
74 |
$0.00 |
| V2781 |
Progressive lens, per lens |
61 |
36 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
17 |
16 |
$0.00 |