| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
11,838 |
11,559 |
$771K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
7,329 |
7,097 |
$633K |
| V2020 |
Frames, purchases |
16,685 |
16,011 |
$467K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
12,893 |
12,688 |
$369K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13,610 |
13,259 |
$290K |
| 92250 |
|
2,553 |
2,407 |
$103K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,634 |
2,344 |
$101K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
2,772 |
2,667 |
$87K |
| 92341 |
|
3,089 |
3,028 |
$73K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
9,340 |
9,044 |
$70K |
| 92133 |
|
1,707 |
1,644 |
$58K |
| 92083 |
|
778 |
739 |
$36K |
| 92370 |
|
930 |
912 |
$26K |
| 92015 |
Determination of refractive state |
2,643 |
2,427 |
$25K |
| V2760 |
Scratch resistant coating, per lens |
9,007 |
8,830 |
$17K |
| 76514 |
|
1,556 |
1,496 |
$12K |
| 92020 |
|
497 |
467 |
$8K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
78 |
78 |
$4K |
| 92002 |
|
39 |
39 |
$2K |
| 92134 |
|
29 |
26 |
$898.93 |
| S9999 |
Sales tax |
27 |
26 |
$37.77 |