| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,650 |
3,519 |
$159K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,089 |
2,025 |
$94K |
| V2020 |
Frames, purchases |
4,627 |
4,525 |
$79K |
| 92015 |
Determination of refractive state |
3,525 |
3,358 |
$78K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
717 |
700 |
$41K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,699 |
1,682 |
$29K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,569 |
1,533 |
$29K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
354 |
354 |
$13K |
| 92250 |
|
70 |
70 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
25 |
25 |
$1K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
44 |
43 |
$672.00 |