| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
6,925 |
6,916 |
$116K |
| 92225 |
|
1,788 |
1,786 |
$67K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,738 |
1,735 |
$34K |
| 92283 |
|
1,772 |
1,771 |
$32K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,405 |
1,404 |
$23K |
| 92015 |
Determination of refractive state |
4,292 |
4,278 |
$11K |
| V2020 |
Frames, purchases |
5,555 |
5,539 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,804 |
3,337 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
166 |
164 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,916 |
2,048 |
$6K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
970 |
850 |
$3K |
| 92285 |
|
13 |
13 |
$235.60 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
371 |
371 |
$79.20 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,278 |
687 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
103 |
103 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
91 |
52 |
$0.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
13 |
13 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
346 |
193 |
$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 |
24 |
12 |
$0.00 |