| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,692 |
3,520 |
$240K |
| V2020 |
Frames, purchases |
4,205 |
3,844 |
$103K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,455 |
3,312 |
$101K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,092 |
1,052 |
$96K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,168 |
1,000 |
$43K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,289 |
2,098 |
$36K |
| 92015 |
Determination of refractive state |
4,981 |
4,758 |
$28K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,998 |
2,784 |
$24K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,254 |
1,182 |
$21K |
| 92250 |
|
248 |
213 |
$9K |
| V2760 |
Scratch resistant coating, per lens |
2,663 |
2,541 |
$6K |
| 92370 |
|
215 |
209 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
28 |
26 |
$2K |
| 92341 |
|
68 |
62 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
14 |
$872.30 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
33 |
28 |
$828.12 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
31 |
30 |
$383.20 |
| 2023F |
|
15 |
15 |
$0.00 |