| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
19,534 |
19,388 |
$339K |
| 92250 |
|
5,257 |
5,115 |
$146K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,572 |
4,546 |
$82K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,668 |
2,480 |
$63K |
| 92286 |
|
5,073 |
4,919 |
$51K |
| V2020 |
Frames, purchases |
14,451 |
14,336 |
$35K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13,464 |
7,274 |
$33K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
21,144 |
11,377 |
$33K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,568 |
2,556 |
$32K |
| 92015 |
Determination of refractive state |
12,814 |
12,636 |
$31K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
4,404 |
2,291 |
$4K |
| 92341 |
|
40 |
40 |
$680.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
27 |
27 |
$634.50 |
| 92202 |
|
91 |
90 |
$402.52 |
| 92133 |
|
13 |
13 |
$264.77 |
| V2750 |
Anti-reflective coating, per lens |
270 |
133 |
$0.00 |
| V2025 |
Deluxe frame |
55 |
54 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
204 |
102 |
$0.00 |
| V2755 |
U-v lens, per lens |
20 |
20 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
730 |
365 |
$0.00 |
| S0500 |
Disposable contact lens, per lens |
12 |
12 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
30 |
14 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
90 |
45 |
$0.00 |