| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
6,764 |
6,668 |
$327K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,293 |
5,210 |
$208K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12,003 |
6,162 |
$185K |
| 92015 |
Determination of refractive state |
10,483 |
10,248 |
$116K |
| 92065 |
|
5,097 |
1,139 |
$113K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,285 |
2,103 |
$77K |
| 92250 |
|
1,100 |
1,063 |
$38K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,557 |
2,458 |
$34K |
| 92060 |
|
931 |
918 |
$31K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,501 |
760 |
$28K |
| 92002 |
|
690 |
680 |
$22K |
| V2020 |
Frames, purchases |
1,359 |
1,347 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
390 |
357 |
$10K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,176 |
617 |
$9K |
| 92341 |
|
317 |
302 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
739 |
375 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13,662 |
6,942 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
111 |
93 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
78 |
73 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
40 |
36 |
$939.89 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
47 |
46 |
$837.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
18 |
15 |
$417.50 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
53 |
26 |
$287.56 |
| 99072 |
|
3,662 |
3,494 |
$0.00 |