| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,490 |
3,478 |
$148K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,300 |
1,855 |
$99K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
849 |
848 |
$81K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
288 |
287 |
$34K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
900 |
761 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
242 |
210 |
$11K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
203 |
136 |
$11K |
| 92133 |
|
345 |
345 |
$11K |
| 92083 |
|
171 |
168 |
$9K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
127 |
112 |
$9K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
16 |
12 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
53 |
52 |
$3K |
| 92015 |
Determination of refractive state |
164 |
164 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
80 |
69 |
$1K |
| 92002 |
|
15 |
15 |
$998.70 |
| 92020 |
|
27 |
27 |
$560.42 |
| 92250 |
|
12 |
12 |
$519.10 |
| 83861 |
|
15 |
12 |
$405.42 |