| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,132 |
3,086 |
$247K |
| V2020 |
Frames, purchases |
4,936 |
4,809 |
$148K |
| 92250 |
|
4,218 |
4,168 |
$100K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,316 |
1,313 |
$93K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,475 |
4,376 |
$87K |
| 92015 |
Determination of refractive state |
4,878 |
4,822 |
$53K |
| 92060 |
|
1,348 |
1,336 |
$45K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,993 |
2,418 |
$30K |
| 92341 |
|
1,176 |
1,126 |
$25K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
215 |
208 |
$15K |
| 92083 |
|
425 |
412 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,342 |
864 |
$8K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
623 |
363 |
$5K |
| 92273 |
|
46 |
46 |
$3K |
| 92283 |
|
60 |
60 |
$2K |
| 92082 |
|
65 |
63 |
$1K |
| 92133 |
|
58 |
58 |
$1K |
| 92002 |
|
16 |
14 |
$505.91 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$491.30 |
| 92370 |
|
15 |
15 |
$273.45 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
19 |
12 |
$202.73 |
| 76514 |
|
24 |
24 |
$148.28 |
| V2756 |
Eye glass case |
580 |
574 |
$135.29 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
18 |
12 |
$121.14 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
68 |
66 |
$0.00 |