| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,347 |
2,335 |
$106K |
| 92015 |
Determination of refractive state |
3,072 |
3,050 |
$64K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
873 |
865 |
$58K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,297 |
1,212 |
$56K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,171 |
2,124 |
$46K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
470 |
468 |
$23K |
| 92250 |
|
638 |
636 |
$21K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
89 |
86 |
$8K |
| 92083 |
|
178 |
175 |
$5K |
| 92133 |
|
100 |
100 |
$2K |
| 92341 |
|
39 |
38 |
$1K |
| 83861 |
|
53 |
26 |
$798.09 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
362 |
354 |
$528.00 |
| V2020 |
Frames, purchases |
2,207 |
2,163 |
$527.00 |
| 83516 |
|
26 |
13 |
$277.68 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,375 |
2,326 |
$145.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,441 |
1,414 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
13 |
13 |
$0.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$0.00 |