| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,513 |
3,367 |
$248K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,597 |
1,532 |
$139K |
| V2020 |
Frames, purchases |
4,862 |
4,580 |
$77K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,355 |
2,245 |
$65K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,302 |
2,229 |
$30K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,416 |
1,322 |
$28K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,615 |
1,516 |
$17K |
| 92015 |
Determination of refractive state |
4,012 |
3,722 |
$9K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
45 |
45 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
12 |
$761.62 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
20 |
13 |
$753.23 |
| 92341 |
|
16 |
16 |
$279.30 |
| 3072F |
|
92 |
85 |
$0.00 |