| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,739 |
2,659 |
$230K |
| 92250 |
|
2,249 |
2,178 |
$110K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
748 |
731 |
$77K |
| V2020 |
Frames, purchases |
4,622 |
4,225 |
$67K |
| 92015 |
Determination of refractive state |
4,086 |
3,781 |
$49K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,434 |
2,333 |
$47K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
657 |
630 |
$27K |
| 92082 |
|
1,545 |
1,487 |
$25K |
| 92273 |
|
141 |
139 |
$13K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
652 |
627 |
$13K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
311 |
295 |
$13K |
| V2750 |
Anti-reflective coating, per lens |
341 |
334 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
329 |
323 |
$11K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
590 |
567 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
330 |
243 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
964 |
805 |
$6K |
| 92134 |
|
91 |
88 |
$3K |
| 92133 |
|
24 |
24 |
$796.55 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
12 |
$523.45 |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
12 |
12 |
$270.52 |
| 76514 |
|
12 |
12 |
$116.68 |