| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,088 |
4,697 |
$218K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,557 |
4,117 |
$201K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,271 |
2,827 |
$164K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,609 |
2,076 |
$116K |
| 92015 |
Determination of refractive state |
6,953 |
6,370 |
$104K |
| V2020 |
Frames, purchases |
2,447 |
2,252 |
$56K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
595 |
504 |
$38K |
| 92285 |
|
1,371 |
1,092 |
$35K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
241 |
196 |
$27K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
649 |
543 |
$25K |
| V2025 |
Deluxe frame |
1,568 |
1,304 |
$19K |
| 92250 |
|
449 |
381 |
$15K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,162 |
1,140 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
754 |
718 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
115 |
109 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
158 |
157 |
$4K |
| 92083 |
|
33 |
24 |
$1K |
| 92225 |
|
13 |
12 |
$631.32 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
16 |
16 |
$117.84 |
| V2760 |
Scratch resistant coating, per lens |
68 |
35 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
92 |
53 |
$0.00 |