| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,611 |
5,586 |
$232K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
8,968 |
5,306 |
$174K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,392 |
2,385 |
$112K |
| V2020 |
Frames, purchases |
6,955 |
6,875 |
$90K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,228 |
1,184 |
$45K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,453 |
857 |
$40K |
| 92015 |
Determination of refractive state |
878 |
874 |
$14K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
7,618 |
4,323 |
$13K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
196 |
195 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
644 |
322 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
551 |
551 |
$8K |
| 92133 |
|
175 |
174 |
$5K |
| 92083 |
|
52 |
52 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
97 |
94 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
34 |
34 |
$1K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
44 |
44 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
28 |
14 |
$457.28 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
24 |
12 |
$328.64 |
| 92020 |
|
12 |
12 |
$180.27 |