| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,014 |
2,900 |
$199K |
| V2020 |
Frames, purchases |
3,410 |
3,259 |
$105K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,102 |
1,044 |
$95K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,965 |
2,837 |
$84K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,187 |
2,025 |
$43K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,310 |
2,206 |
$18K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
788 |
717 |
$16K |
| V2760 |
Scratch resistant coating, per lens |
2,359 |
2,243 |
$4K |
| V2755 |
U-v lens, per lens |
185 |
182 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
35 |
27 |
$1K |
| 92370 |
|
28 |
27 |
$812.00 |
| 92015 |
Determination of refractive state |
3,595 |
3,422 |
$444.84 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
174 |
172 |
$0.00 |