| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,374 |
3,308 |
$123K |
| 92250 |
|
1,238 |
1,236 |
$36K |
| 92083 |
|
1,054 |
1,053 |
$31K |
| 95930 |
|
613 |
612 |
$27K |
| V2020 |
Frames, purchases |
1,471 |
1,457 |
$25K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
735 |
716 |
$25K |
| 92273 |
|
484 |
481 |
$15K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
628 |
628 |
$14K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
497 |
486 |
$11K |
| 92020 |
|
1,182 |
1,175 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
63 |
62 |
$5K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
406 |
239 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
922 |
580 |
$3K |
| 92133 |
|
78 |
78 |
$1K |
| 92275 |
|
26 |
26 |
$981.07 |
| 92226 |
|
45 |
27 |
$590.48 |
| V2201 |
Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens |
44 |
26 |
$544.50 |
| 0509T |
|
15 |
15 |
$424.13 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
12 |
12 |
$348.00 |
| 92201 |
|
43 |
43 |
$305.62 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
494 |
472 |
$175.00 |
| 92134 |
|
28 |
27 |
$160.15 |
| 92202 |
|
12 |
12 |
$24.91 |
| 92015 |
Determination of refractive state |
241 |
239 |
$0.00 |
| V2756 |
Eye glass case |
472 |
453 |
$0.00 |