| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
919 |
894 |
$24K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
793 |
756 |
$18K |
| 92015 |
Determination of refractive state |
1,304 |
1,273 |
$13K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
774 |
756 |
$10K |
| V2020 |
Frames, purchases |
1,141 |
1,048 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
871 |
819 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
93 |
82 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$187.92 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
15 |
14 |
$185.94 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
849 |
832 |
$87.83 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
14 |
13 |
$45.00 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
63 |
60 |
$0.00 |