| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,675 |
3,654 |
$189K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,963 |
2,937 |
$176K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,849 |
3,045 |
$97K |
| V2020 |
Frames, purchases |
4,023 |
3,983 |
$40K |
| 92250 |
|
742 |
731 |
$32K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
478 |
467 |
$19K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,217 |
1,212 |
$18K |
| 92015 |
Determination of refractive state |
558 |
557 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
242 |
239 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
107 |
105 |
$6K |
| 92201 |
|
344 |
340 |
$6K |
| 92225 |
|
207 |
144 |
$4K |
| 92202 |
|
161 |
159 |
$2K |
| 92226 |
|
102 |
82 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
99 |
54 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
214 |
111 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
14 |
14 |
$595.64 |
| 92083 |
|
12 |
12 |
$594.09 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
214 |
107 |
$0.00 |
| 2022F |
|
12 |
12 |
$0.00 |
| 2024F |
|
26 |
26 |
$0.00 |