| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
7,250 |
6,814 |
$503K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
5,654 |
5,338 |
$477K |
| V2020 |
Frames, purchases |
15,685 |
14,674 |
$247K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12,064 |
11,718 |
$153K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
6,850 |
6,368 |
$144K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,158 |
4,686 |
$114K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,222 |
1,087 |
$68K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
440 |
386 |
$25K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,925 |
1,610 |
$17K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
244 |
240 |
$6K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
111 |
110 |
$3K |
| V2781 |
Progressive lens, per lens |
26 |
25 |
$2K |
| V2799 |
Vision item or service, miscellaneous |
218 |
214 |
$2K |
| 3072F |
|
1,355 |
1,313 |
$740.00 |
| V2299 |
Specialty bifocal (by report) |
12 |
12 |
$707.22 |
| V2025 |
Deluxe frame |
13 |
13 |
$517.80 |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
15 |
14 |
$354.68 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
31 |
31 |
$137.72 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
115 |
113 |
$69.00 |
| 92015 |
Determination of refractive state |
1,312 |
982 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
25 |
24 |
$0.00 |