| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,662 |
4,598 |
$191K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,072 |
2,059 |
$90K |
| 92015 |
Determination of refractive state |
4,221 |
4,144 |
$40K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
231 |
230 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
213 |
209 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
207 |
202 |
$8K |
| 92341 |
|
200 |
189 |
$4K |
| V2020 |
Frames, purchases |
273 |
261 |
$3K |
| 92250 |
|
66 |
65 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
15 |
$968.77 |
| 92310 |
|
13 |
13 |
$775.06 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
27 |
27 |
$582.02 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$298.56 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
17 |
17 |
$227.72 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
12 |
12 |
$170.84 |
| 3072F |
|
189 |
189 |
$170.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$113.05 |
| 2022F |
|
1,147 |
1,142 |
$20.00 |