| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,723 |
1,712 |
$77K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,638 |
1,629 |
$71K |
| 92015 |
Determination of refractive state |
3,079 |
3,034 |
$59K |
| V2020 |
Frames, purchases |
3,275 |
3,237 |
$56K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
796 |
789 |
$48K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,466 |
2,443 |
$44K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,783 |
1,769 |
$29K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
690 |
682 |
$29K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
652 |
578 |
$28K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
316 |
314 |
$21K |
| 92250 |
|
437 |
427 |
$13K |
| 92341 |
|
451 |
449 |
$9K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
121 |
118 |
$5K |
| 92370 |
|
284 |
277 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
15 |
15 |
$693.93 |