| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
7,012 |
6,716 |
$272K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,268 |
4,359 |
$184K |
| 92015 |
Determination of refractive state |
7,140 |
6,759 |
$169K |
| V2020 |
Frames, purchases |
8,009 |
7,658 |
$124K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
7,025 |
6,710 |
$115K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,175 |
2,065 |
$109K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,149 |
1,864 |
$99K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
4,183 |
3,890 |
$77K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,753 |
1,486 |
$54K |
| 92250 |
|
1,388 |
1,230 |
$45K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
922 |
751 |
$45K |
| 92341 |
|
994 |
933 |
$19K |
| 92083 |
|
315 |
269 |
$10K |
| 92133 |
|
436 |
302 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
216 |
209 |
$6K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
230 |
164 |
$6K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
185 |
143 |
$6K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
88 |
70 |
$3K |