| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
34,485 |
34,390 |
$1.31M |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
14,740 |
14,715 |
$1.05M |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
11,250 |
11,226 |
$959K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
27,962 |
27,871 |
$641K |
| 92015 |
Determination of refractive state |
30,466 |
30,353 |
$341K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
20,890 |
20,822 |
$296K |
| 92341 |
|
7,258 |
7,240 |
$186K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,394 |
2,376 |
$157K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,382 |
3,117 |
$152K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,999 |
5,990 |
$87K |
| 92250 |
|
3,112 |
3,099 |
$79K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,390 |
1,390 |
$68K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,850 |
5,833 |
$63K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
866 |
863 |
$41K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,168 |
1,056 |
$32K |
| 92060 |
|
834 |
827 |
$30K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
242 |
242 |
$22K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
1,686 |
1,681 |
$22K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,562 |
1,554 |
$21K |
| 92133 |
|
876 |
870 |
$18K |
| 99406 |
|
1,842 |
1,836 |
$16K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
334 |
332 |
$16K |
| 92083 |
|
402 |
399 |
$14K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,291 |
1,286 |
$13K |
| 92002 |
|
138 |
138 |
$6K |
| 92285 |
|
335 |
329 |
$4K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
344 |
342 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
49 |
49 |
$3K |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
175 |
174 |
$2K |
| V2207 |
Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens |
102 |
102 |
$2K |
| 92342 |
|
51 |
51 |
$1K |
| V2204 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
87 |
87 |
$912.38 |
| V2799 |
Vision item or service, miscellaneous |
94 |
94 |
$860.30 |
| 92134 |
|
38 |
38 |
$853.06 |
| V2715 |
Prism, per lens |
119 |
119 |
$852.12 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
26 |
26 |
$314.08 |
| V2111 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens |
12 |
12 |
$224.07 |
| 2022F |
|
762 |
758 |
$0.00 |
| 2025F |
|
14 |
14 |
$0.00 |
| V2756 |
Eye glass case |
225 |
225 |
$0.00 |
| 2023F |
|
246 |
246 |
$0.00 |
| 3072F |
|
70 |
70 |
$0.00 |