| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
18,039 |
16,585 |
$392K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,718 |
4,679 |
$87K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,397 |
1,365 |
$58K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,023 |
3,006 |
$41K |
| 92015 |
Determination of refractive state |
10,192 |
10,136 |
$21K |
| 99215 |
Prolong outpt/office vis |
41 |
41 |
$3K |
| V2020 |
Frames, purchases |
11,232 |
11,069 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
14,108 |
7,920 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13,085 |
7,103 |
$2K |
| V2300 |
Sphere, trifocal, plano to plus or minus 4.00d, per lens |
56 |
56 |
$39.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,736 |
915 |
$34.00 |
| 2022F |
|
195 |
187 |
$0.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
222 |
222 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
47 |
25 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
361 |
212 |
$0.00 |
| 2023F |
|
58 |
56 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
340 |
173 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
156 |
82 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
79 |
79 |
$0.00 |
| V2781 |
Progressive lens, per lens |
158 |
77 |
$0.00 |
| V2299 |
Specialty bifocal (by report) |
26 |
16 |
$0.00 |