| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
6,062 |
5,657 |
$245K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,995 |
5,637 |
$176K |
| 92015 |
Determination of refractive state |
9,230 |
8,694 |
$162K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
3,487 |
3,222 |
$74K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,397 |
1,303 |
$63K |
| V2020 |
Frames, purchases |
826 |
782 |
$22K |
| 92341 |
|
716 |
702 |
$21K |
| 92002 |
|
607 |
579 |
$15K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
123 |
105 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
179 |
175 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
26 |
25 |
$944.05 |
| V2025 |
Deluxe frame |
40 |
16 |
$432.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
76 |
69 |
$390.00 |
| 92134 |
|
14 |
14 |
$159.11 |
| 92202 |
|
20 |
17 |
$119.34 |
| 3072F |
|
117 |
114 |
$0.00 |