| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,757 |
3,527 |
$230K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,900 |
1,754 |
$150K |
| V2020 |
Frames, purchases |
4,591 |
4,409 |
$130K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,377 |
3,245 |
$97K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,794 |
2,031 |
$37K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,578 |
2,477 |
$28K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,289 |
937 |
$21K |
| V2760 |
Scratch resistant coating, per lens |
3,178 |
3,078 |
$17K |
| 92015 |
Determination of refractive state |
5,633 |
5,212 |
$17K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
531 |
529 |
$15K |
| 92341 |
|
170 |
170 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
132 |
114 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
139 |
113 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
167 |
150 |
$3K |
| 92250 |
|
58 |
55 |
$2K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
14 |
14 |
$558.84 |
| 92370 |
|
17 |
13 |
$348.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
24 |
24 |
$315.00 |