| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,861 |
1,851 |
$116K |
| V2020 |
Frames, purchases |
1,506 |
1,506 |
$70K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,869 |
1,868 |
$53K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
383 |
383 |
$36K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
873 |
871 |
$36K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
112 |
112 |
$15K |
| 92201 |
|
678 |
678 |
$13K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
135 |
123 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
93 |
93 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
50 |
50 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
58 |
58 |
$5K |
| 92225 |
|
99 |
99 |
$2K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
89 |
89 |
$1K |