| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
9,973 |
9,555 |
$641K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,859 |
4,637 |
$405K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
20,304 |
19,108 |
$332K |
| V2750 |
Anti-reflective coating, per lens |
3,953 |
3,811 |
$279K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
19,553 |
18,306 |
$240K |
| V2020 |
Frames, purchases |
18,990 |
18,142 |
$201K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
11,165 |
10,716 |
$160K |
| 92015 |
Determination of refractive state |
19,960 |
18,931 |
$150K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,304 |
2,748 |
$29K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
427 |
387 |
$16K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
296 |
294 |
$7K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
138 |
137 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
24 |
24 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
14 |
$971.10 |
| 92250 |
|
30 |
28 |
$748.87 |
| 92133 |
|
24 |
24 |
$632.03 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
13 |
13 |
$462.00 |