| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
8,345 |
6,540 |
$361K |
| 65778 |
|
1,967 |
827 |
$261K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,984 |
2,764 |
$212K |
| V2025 |
Deluxe frame |
1,992 |
1,961 |
$130K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,465 |
2,427 |
$75K |
| 99215 |
Prolong outpt/office vis |
1,665 |
1,286 |
$58K |
| 68761 |
|
2,161 |
791 |
$51K |
| 99205 |
Prolong outpt/office vis |
697 |
568 |
$45K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
859 |
795 |
$30K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
681 |
642 |
$20K |
| V2020 |
Frames, purchases |
1,996 |
1,919 |
$20K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,405 |
1,384 |
$19K |
| 92250 |
|
635 |
517 |
$12K |
| 92083 |
|
403 |
295 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
405 |
399 |
$5K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
60 |
60 |
$4K |
| 92133 |
|
396 |
304 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
81 |
80 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
78 |
62 |
$2K |
| 92015 |
Determination of refractive state |
130 |
130 |
$1K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
14 |
14 |
$1K |
| 92020 |
|
16 |
12 |
$64.68 |