| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,039 |
2,031 |
$123K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,708 |
1,674 |
$98K |
| 92250 |
|
3,034 |
3,005 |
$51K |
| 92015 |
Determination of refractive state |
2,981 |
2,838 |
$29K |
| V2020 |
Frames, purchases |
1,235 |
1,230 |
$25K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
578 |
574 |
$24K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
291 |
287 |
$23K |
| 92133 |
|
1,052 |
1,047 |
$17K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,099 |
1,089 |
$16K |
| 92273 |
|
247 |
246 |
$15K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
191 |
174 |
$13K |
| 92020 |
|
981 |
976 |
$12K |
| 92025 |
|
612 |
607 |
$12K |
| 92341 |
|
664 |
660 |
$11K |
| 92083 |
|
264 |
260 |
$8K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
226 |
212 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
673 |
671 |
$5K |
| 76514 |
|
999 |
997 |
$5K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
432 |
431 |
$5K |
| 92134 |
|
205 |
204 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
62 |
53 |
$3K |
| 92342 |
|
17 |
13 |
$297.75 |
| 92499 |
|
283 |
282 |
$22.57 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
140 |
140 |
$18.00 |
| V2756 |
Eye glass case |
28 |
28 |
$0.00 |
| 2024F |
|
2,339 |
2,311 |
$0.00 |
| V2025 |
Deluxe frame |
22 |
22 |
$0.00 |