| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
8,876 |
8,722 |
$181K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
6,481 |
2,845 |
$74K |
| V2020 |
Frames, purchases |
7,892 |
7,285 |
$70K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,317 |
3,277 |
$51K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
464 |
448 |
$14K |
| 92015 |
Determination of refractive state |
457 |
457 |
$11K |
| 92060 |
|
278 |
277 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,358 |
2,148 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
9,665 |
4,340 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
84 |
84 |
$4K |
| V2760 |
Scratch resistant coating, per lens |
938 |
461 |
$945.00 |
| V2750 |
Anti-reflective coating, per lens |
2,142 |
1,069 |
$638.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
13 |
$612.22 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,008 |
505 |
$597.12 |
| 92250 |
|
15 |
14 |
$505.68 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
456 |
227 |
$355.44 |
| V2744 |
Tint, photochromatic, per lens |
1,091 |
546 |
$340.00 |
| V2781 |
Progressive lens, per lens |
887 |
442 |
$230.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
290 |
145 |
$111.88 |
| V2299 |
Specialty bifocal (by report) |
342 |
171 |
$72.08 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
456 |
227 |
$53.48 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
15 |
14 |
$22.00 |
| 2022F |
|
16 |
16 |
$0.00 |
| G8397 |
Dilated macular or fundus exam performed, including documentation of the presence or absence of macular edema and level of severity of retinopathy |
16 |
16 |
$0.00 |