| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,606 |
1,512 |
$165K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,044 |
989 |
$86K |
| 92250 |
|
1,979 |
1,851 |
$70K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
658 |
574 |
$45K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
445 |
250 |
$30K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
539 |
296 |
$17K |
| V2020 |
Frames, purchases |
289 |
278 |
$16K |
| V2750 |
Anti-reflective coating, per lens |
568 |
311 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
221 |
115 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
67 |
61 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
87 |
87 |
$2K |
| 92133 |
|
39 |
38 |
$1K |
| 92015 |
Determination of refractive state |
275 |
238 |
$1K |
| 92002 |
|
13 |
12 |
$841.80 |
| 92285 |
|
14 |
14 |
$161.40 |