| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,646 |
2,632 |
$186K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,008 |
2,000 |
$166K |
| 92060 |
|
3,480 |
3,464 |
$123K |
| V2020 |
Frames, purchases |
3,976 |
3,962 |
$121K |
| 92082 |
|
3,303 |
3,276 |
$83K |
| 92015 |
Determination of refractive state |
4,813 |
4,732 |
$54K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,014 |
2,009 |
$41K |
| 92285 |
|
3,228 |
3,179 |
$40K |
| 92342 |
|
1,527 |
1,523 |
$38K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,090 |
2,035 |
$31K |
| 92341 |
|
992 |
989 |
$23K |
| 92250 |
|
719 |
711 |
$14K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
610 |
602 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
184 |
182 |
$9K |
| 92083 |
|
146 |
145 |
$5K |
| 92201 |
|
381 |
378 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
302 |
302 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
152 |
151 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
14 |
$946.00 |
| 92273 |
|
14 |
13 |
$869.51 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
16 |
15 |
$853.05 |
| V2755 |
U-v lens, per lens |
2,179 |
2,175 |
$742.68 |
| 92081 |
|
14 |
14 |
$295.26 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
15 |
14 |
$294.50 |
| V2760 |
Scratch resistant coating, per lens |
537 |
536 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,403 |
1,399 |
$0.00 |