| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,778 |
1,651 |
$141K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,461 |
1,373 |
$126K |
| V2020 |
Frames, purchases |
2,843 |
2,575 |
$76K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,768 |
1,036 |
$18K |
| 92015 |
Determination of refractive state |
3,224 |
3,030 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,346 |
2,124 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
50 |
47 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,727 |
1,461 |
$2K |
| 92341 |
|
41 |
41 |
$420.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
45 |
26 |
$352.35 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
165 |
106 |
$254.13 |
| 92250 |
|
14 |
12 |
$60.00 |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
59 |
39 |
$12.18 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
13 |
13 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
79 |
14 |
$0.00 |