| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,841 |
1,649 |
$139K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,352 |
1,158 |
$110K |
| V2020 |
Frames, purchases |
3,472 |
3,139 |
$29K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,478 |
3,161 |
$22K |
| 92015 |
Determination of refractive state |
3,373 |
3,008 |
$13K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,913 |
1,749 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,050 |
846 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
55 |
51 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
50 |
44 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,435 |
2,212 |
$3K |
| 92250 |
|
205 |
182 |
$2K |
| 68761 |
|
26 |
12 |
$1K |
| 92060 |
|
120 |
66 |
$316.07 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
40 |
37 |
$212.64 |
| 92310 |
|
12 |
12 |
$0.00 |
| V2755 |
U-v lens, per lens |
60 |
58 |
$0.00 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
16 |
12 |
$0.00 |