| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
988 |
906 |
$28K |
| V2020 |
Frames, purchases |
1,264 |
1,123 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,002 |
889 |
$13K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
360 |
327 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
419 |
340 |
$5K |
| 92015 |
Determination of refractive state |
322 |
320 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
271 |
247 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
102 |
85 |
$2K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
42 |
42 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
17 |
17 |
$850.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
58 |
53 |
$638.50 |
| 92341 |
|
13 |
13 |
$348.81 |
| 92250 |
|
14 |
13 |
$205.78 |
| V2750 |
Anti-reflective coating, per lens |
56 |
52 |
$0.00 |