| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,968 |
2,867 |
$210K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,860 |
1,782 |
$163K |
| V2020 |
Frames, purchases |
4,538 |
4,017 |
$64K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,517 |
2,291 |
$47K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,413 |
1,386 |
$18K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
862 |
803 |
$10K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
185 |
157 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
326 |
306 |
$6K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
89 |
51 |
$3K |
| 92310 |
|
42 |
41 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
46 |
38 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
61 |
55 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
93 |
81 |
$2K |
| 92341 |
|
25 |
25 |
$296.64 |
| 92015 |
Determination of refractive state |
33 |
33 |
$0.00 |