| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,968 |
4,755 |
$228K |
| 92083 |
|
2,250 |
2,186 |
$110K |
| 92134 |
|
4,163 |
3,925 |
$81K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
3,335 |
2,996 |
$78K |
| V2201 |
Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens |
627 |
511 |
$62K |
| 92015 |
Determination of refractive state |
4,380 |
4,147 |
$56K |
| V2020 |
Frames, purchases |
703 |
656 |
$52K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
619 |
581 |
$40K |
| 92250 |
|
988 |
938 |
$38K |
| 92341 |
|
701 |
670 |
$25K |
| 92020 |
|
1,382 |
1,308 |
$20K |
| 92133 |
|
898 |
870 |
$18K |
| 66761 |
|
33 |
25 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
113 |
112 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
98 |
93 |
$3K |
| 76514 |
|
422 |
404 |
$2K |
| V2756 |
Eye glass case |
1,035 |
991 |
$2K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
14 |
13 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13 |
12 |
$1K |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
1,775 |
1,480 |
$1.04 |
| 1036F |
|
4,532 |
3,842 |
$0.03 |
| G8482 |
Influenza immunization administered or previously received |
425 |
376 |
$0.01 |
| 4004F |
|
93 |
74 |
$0.00 |
| V2025 |
Deluxe frame |
330 |
330 |
$0.00 |
| 2022F |
|
41 |
28 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
148 |
148 |
$0.00 |