| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,012 |
945 |
$45K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
692 |
659 |
$26K |
| V2020 |
Frames, purchases |
1,636 |
1,536 |
$25K |
| 92015 |
Determination of refractive state |
939 |
892 |
$21K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
991 |
929 |
$16K |
| 92250 |
|
368 |
361 |
$9K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
137 |
124 |
$8K |
| 92341 |
|
195 |
179 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
147 |
140 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
42 |
40 |
$3K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
30 |
27 |
$532.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$459.85 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
15 |
12 |
$313.06 |