| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,052 |
4,005 |
$161K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,654 |
3,611 |
$147K |
| V2020 |
Frames, purchases |
6,170 |
6,081 |
$99K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,829 |
3,776 |
$82K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,546 |
3,500 |
$76K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,114 |
1,098 |
$72K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
923 |
902 |
$70K |
| 92341 |
|
1,239 |
1,220 |
$32K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,354 |
3,298 |
$29K |
| 92015 |
Determination of refractive state |
1,893 |
1,872 |
$29K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
827 |
819 |
$26K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
140 |
138 |
$3K |
| 92342 |
|
81 |
79 |
$2K |
| V2781 |
Progressive lens, per lens |
40 |
40 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
40 |
40 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
21 |
21 |
$915.81 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
14 |
$808.64 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$440.00 |
| V2025 |
Deluxe frame |
40 |
40 |
$390.00 |
| 92002 |
|
15 |
14 |
$383.46 |
| 3072F |
|
69 |
67 |
$20.00 |
| 2023F |
|
12 |
12 |
$0.00 |