| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,546 |
2,498 |
$110K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,881 |
1,857 |
$56K |
| 92015 |
Determination of refractive state |
2,469 |
2,411 |
$45K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
678 |
655 |
$40K |
| V2020 |
Frames, purchases |
2,663 |
2,621 |
$18K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,509 |
1,492 |
$16K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,038 |
1,031 |
$16K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
29 |
26 |
$809.28 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
28 |
27 |
$339.06 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
166 |
164 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
55 |
55 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
25 |
25 |
$0.00 |
| V2781 |
Progressive lens, per lens |
54 |
54 |
$0.00 |