| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,745 |
2,804 |
$156K |
| V2020 |
Frames, purchases |
3,836 |
3,522 |
$153K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
3,396 |
3,327 |
$126K |
| 92002 |
|
1,952 |
1,920 |
$76K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,132 |
1,127 |
$47K |
| 92134 |
|
1,162 |
1,153 |
$31K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
798 |
700 |
$22K |
| 92083 |
|
381 |
380 |
$21K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,286 |
1,985 |
$16K |
| 92015 |
Determination of refractive state |
1,578 |
1,564 |
$8K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
187 |
101 |
$7K |
| V2744 |
Tint, photochromatic, per lens |
228 |
113 |
$7K |
| V2750 |
Anti-reflective coating, per lens |
232 |
115 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
235 |
234 |
$4K |
| V2781 |
Progressive lens, per lens |
58 |
29 |
$2K |
| V2299 |
Specialty bifocal (by report) |
58 |
29 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
38 |
38 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$894.66 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
30 |
14 |
$802.20 |
| V2760 |
Scratch resistant coating, per lens |
50 |
24 |
$445.00 |
| 2022F |
|
12 |
12 |
$0.00 |
| G8731 |
Pain assessment using a standardized tool is documented as negative, no follow-up plan required |
35 |
35 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
32 |
32 |
$0.00 |
| 1036F |
|
29 |
29 |
$0.00 |