| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,015 |
1,014 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
292 |
269 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
824 |
824 |
$4K |
| 92015 |
Determination of refractive state |
397 |
397 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
46 |
41 |
$1K |
| V2020 |
Frames, purchases |
1,168 |
1,148 |
$348.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
14 |
14 |
$200.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
508 |
256 |
$76.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
12 |
12 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
430 |
212 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
16 |
16 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
36 |
16 |
$0.00 |