| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,031 |
3,856 |
$188K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,058 |
3,961 |
$166K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,054 |
4,746 |
$86K |
| V2020 |
Frames, purchases |
5,098 |
4,852 |
$82K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
2,807 |
2,638 |
$52K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
295 |
288 |
$17K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
295 |
288 |
$14K |
| V2303 |
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens |
69 |
68 |
$6K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
38 |
38 |
$3K |
| 92341 |
|
50 |
50 |
$981.52 |
| 92342 |
|
43 |
43 |
$907.30 |
| 92250 |
|
12 |
12 |
$397.33 |