| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,714 |
5,635 |
$229K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,516 |
3,467 |
$143K |
| V2020 |
Frames, purchases |
5,980 |
5,873 |
$99K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,504 |
4,426 |
$96K |
| 92015 |
Determination of refractive state |
4,787 |
4,591 |
$71K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,993 |
2,896 |
$61K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,224 |
4,140 |
$39K |
| 92341 |
|
950 |
852 |
$20K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
617 |
599 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
330 |
302 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
173 |
142 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$968.77 |
| 92310 |
|
12 |
12 |
$960.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
41 |
35 |
$404.32 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$205.42 |
| V2744 |
Tint, photochromatic, per lens |
27 |
26 |
$11.97 |