| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,716 |
1,707 |
$103K |
| 92250 |
|
1,424 |
1,421 |
$70K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
524 |
523 |
$44K |
| 92083 |
|
789 |
785 |
$41K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
894 |
857 |
$37K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
407 |
407 |
$32K |
| 92060 |
|
836 |
834 |
$32K |
| 92015 |
Determination of refractive state |
2,526 |
2,520 |
$30K |
| V2020 |
Frames, purchases |
2,054 |
2,049 |
$23K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,262 |
1,255 |
$18K |
| 92133 |
|
533 |
532 |
$16K |
| 92201 |
|
647 |
641 |
$12K |
| 92020 |
|
683 |
682 |
$10K |
| 92285 |
|
699 |
692 |
$9K |
| V2219 |
Bifocal seg width over 28 mm |
118 |
117 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
116 |
114 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
382 |
382 |
$5K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
302 |
301 |
$5K |
| 92341 |
|
143 |
142 |
$3K |
| 68761 |
|
25 |
24 |
$3K |
| 92225 |
|
64 |
64 |
$2K |
| 92226 |
|
53 |
52 |
$1K |
| 92202 |
|
68 |
68 |
$932.25 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
50 |
50 |
$470.25 |
| 76514 |
|
40 |
40 |
$313.60 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
13 |
13 |
$140.40 |