| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,762 |
3,371 |
$256K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,339 |
1,213 |
$112K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,947 |
4,457 |
$92K |
| V2020 |
Frames, purchases |
6,652 |
5,875 |
$91K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
4,208 |
3,757 |
$50K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
851 |
801 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
307 |
235 |
$9K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
107 |
97 |
$5K |
| V2799 |
Vision item or service, miscellaneous |
307 |
287 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
160 |
139 |
$3K |
| 92083 |
|
69 |
59 |
$3K |
| 92133 |
|
65 |
54 |
$1K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
20 |
12 |
$582.02 |
| 92015 |
Determination of refractive state |
4,195 |
3,686 |
$0.00 |