| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,204 |
4,069 |
$259K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,674 |
1,623 |
$136K |
| V2750 |
Anti-reflective coating, per lens |
1,072 |
965 |
$98K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,536 |
5,090 |
$92K |
| V2020 |
Frames, purchases |
5,349 |
4,887 |
$69K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,143 |
4,719 |
$67K |
| 92015 |
Determination of refractive state |
6,099 |
5,919 |
$52K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,757 |
4,352 |
$49K |
| V2499 |
Variable sphericity lens, other type |
316 |
293 |
$20K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
304 |
273 |
$18K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
396 |
368 |
$16K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
259 |
251 |
$10K |
| 92250 |
|
133 |
124 |
$5K |
| V2206 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens |
67 |
61 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
49 |
42 |
$1K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
27 |
27 |
$644.00 |
| V2755 |
U-v lens, per lens |
12 |
12 |
$600.00 |
| 92341 |
|
12 |
12 |
$216.00 |