| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
11,177 |
11,085 |
$792K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
19,435 |
17,113 |
$405K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,809 |
4,747 |
$403K |
| 92015 |
Determination of refractive state |
18,727 |
18,603 |
$208K |
| V2020 |
Frames, purchases |
5,486 |
5,444 |
$158K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
994 |
992 |
$68K |
| 92341 |
|
2,754 |
2,736 |
$63K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,635 |
2,447 |
$37K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,625 |
1,515 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
166 |
164 |
$7K |
| 92370 |
|
264 |
258 |
$5K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
173 |
153 |
$3K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
68 |
68 |
$3K |
| 92342 |
|
41 |
41 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
38 |
38 |
$818.62 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
27 |
27 |
$393.04 |
| V2756 |
Eye glass case |
1,279 |
1,263 |
$256.50 |
| 2022F |
|
2,321 |
2,257 |
$0.19 |
| 3072F |
|
220 |
220 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
37 |
37 |
$0.00 |
| 2023F |
|
18 |
18 |
$0.00 |