| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
6,623 |
6,477 |
$763K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,236 |
3,211 |
$361K |
| V2020 |
Frames, purchases |
6,835 |
6,739 |
$252K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,808 |
3,734 |
$110K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,670 |
2,628 |
$77K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,302 |
1,293 |
$48K |
| 92015 |
Determination of refractive state |
7,562 |
7,387 |
$42K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,621 |
3,568 |
$35K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
753 |
753 |
$24K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
2,474 |
2,472 |
$21K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
292 |
291 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
102 |
93 |
$5K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
61 |
61 |
$2K |
| 92341 |
|
58 |
58 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
28 |
28 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$409.56 |
| V2799 |
Vision item or service, miscellaneous |
12 |
12 |
$0.00 |