| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,315 |
2,941 |
$147K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,403 |
3,938 |
$130K |
| 92015 |
Determination of refractive state |
5,635 |
5,053 |
$102K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,051 |
1,815 |
$96K |
| V2025 |
Deluxe frame |
623 |
564 |
$18K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
255 |
219 |
$14K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
298 |
237 |
$13K |
| 92250 |
|
339 |
337 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
422 |
393 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
252 |
239 |
$3K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
108 |
93 |
$2K |
| V2020 |
Frames, purchases |
61 |
61 |
$658.80 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16 |
16 |
$0.00 |