| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,153 |
1,081 |
$88K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,063 |
994 |
$62K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,338 |
3,069 |
$52K |
| V2020 |
Frames, purchases |
3,334 |
3,066 |
$51K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,726 |
2,494 |
$39K |
| 92015 |
Determination of refractive state |
3,329 |
3,058 |
$26K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
935 |
877 |
$17K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
280 |
263 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
506 |
473 |
$9K |
| V2499 |
Variable sphericity lens, other type |
83 |
81 |
$5K |
| 92002 |
|
99 |
86 |
$3K |
| V2750 |
Anti-reflective coating, per lens |
26 |
26 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
25 |
25 |
$963.40 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15 |
12 |
$390.59 |