| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,042 |
3,787 |
$335K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,467 |
3,260 |
$235K |
| V2020 |
Frames, purchases |
8,082 |
7,063 |
$141K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
6,808 |
5,857 |
$124K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,899 |
2,826 |
$36K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,282 |
1,972 |
$25K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
631 |
544 |
$25K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
411 |
404 |
$17K |
| 92015 |
Determination of refractive state |
7,750 |
7,019 |
$14K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
233 |
215 |
$6K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
74 |
74 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
73 |
69 |
$1K |
| 92341 |
|
167 |
149 |
$788.50 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
16 |
13 |
$354.28 |
| V2111 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens |
19 |
17 |
$281.40 |
| V2750 |
Anti-reflective coating, per lens |
66 |
59 |
$0.00 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
430 |
352 |
$0.00 |