| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
5,016 |
4,976 |
$458K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,964 |
2,940 |
$209K |
| 92015 |
Determination of refractive state |
7,645 |
5,792 |
$136K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,043 |
1,849 |
$88K |
| 92225 |
|
2,571 |
1,880 |
$79K |
| V2020 |
Frames, purchases |
935 |
934 |
$57K |
| 92201 |
|
2,591 |
2,575 |
$38K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
357 |
357 |
$28K |
| 92226 |
|
785 |
638 |
$25K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
279 |
278 |
$25K |
| 92202 |
|
1,960 |
1,943 |
$15K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
112 |
112 |
$13K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
439 |
439 |
$9K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
76 |
76 |
$9K |
| 92020 |
|
642 |
640 |
$8K |
| V2219 |
Bifocal seg width over 28 mm |
72 |
72 |
$8K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
69 |
69 |
$7K |
| 99072 |
|
2,019 |
1,974 |
$5K |
| 92250 |
|
153 |
147 |
$3K |
| 92002 |
|
58 |
58 |
$2K |
| 92133 |
|
83 |
82 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
30 |
30 |
$1K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
24 |
24 |
$977.04 |
| 92134 |
|
52 |
48 |
$232.67 |
| 92025 |
|
12 |
12 |
$180.21 |