| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,430 |
2,240 |
$162K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
838 |
754 |
$68K |
| V2020 |
Frames, purchases |
2,550 |
2,205 |
$40K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,112 |
998 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,007 |
866 |
$15K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
856 |
835 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
930 |
827 |
$10K |
| 92015 |
Determination of refractive state |
3,578 |
3,016 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
35 |
27 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15 |
14 |
$918.16 |
| 92250 |
|
13 |
12 |
$382.59 |
| 2026F |
|
50 |
26 |
$0.00 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
23 |
13 |
$0.00 |