| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,460 |
4,147 |
$304K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,543 |
2,411 |
$218K |
| V2020 |
Frames, purchases |
6,136 |
5,659 |
$85K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
4,971 |
4,666 |
$62K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,248 |
1,068 |
$56K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,621 |
3,197 |
$53K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,244 |
1,447 |
$23K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
723 |
686 |
$8K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
132 |
88 |
$5K |
| 92250 |
|
58 |
42 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
95 |
68 |
$946.80 |
| 92083 |
|
17 |
12 |
$391.13 |
| 92133 |
|
12 |
12 |
$255.52 |
| V2799 |
Vision item or service, miscellaneous |
13 |
13 |
$174.36 |
| 92015 |
Determination of refractive state |
19 |
19 |
$0.00 |