| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
7,430 |
7,263 |
$478K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,665 |
5,572 |
$447K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
7,671 |
7,253 |
$223K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,569 |
5,313 |
$217K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,199 |
2,151 |
$209K |
| 92015 |
Determination of refractive state |
8,352 |
8,189 |
$159K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,441 |
1,186 |
$74K |
| 92250 |
|
2,404 |
2,172 |
$71K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
620 |
554 |
$47K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,783 |
1,719 |
$45K |
| V2755 |
U-v lens, per lens |
1,056 |
1,044 |
$44K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
182 |
169 |
$18K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
232 |
212 |
$16K |
| 92370 |
|
118 |
117 |
$5K |
| 92083 |
|
37 |
36 |
$1K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
38 |
38 |
$1K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
40 |
40 |
$1K |
| 92133 |
|
13 |
13 |
$348.15 |