| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,552 |
1,123 |
$69K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,004 |
613 |
$49K |
| V2020 |
Frames, purchases |
2,503 |
1,728 |
$44K |
| 92015 |
Determination of refractive state |
2,032 |
1,196 |
$42K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,019 |
1,356 |
$36K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
186 |
96 |
$12K |
| 92250 |
|
293 |
148 |
$10K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
513 |
269 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
64 |
64 |
$3K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
29 |
28 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
24 |
24 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
14 |
13 |
$952.82 |
| 92341 |
|
43 |
40 |
$905.73 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
28 |
28 |
$489.16 |