| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,015 |
2,950 |
$248K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,593 |
1,574 |
$133K |
| V2020 |
Frames, purchases |
7,099 |
6,902 |
$112K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
955 |
925 |
$69K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,405 |
1,905 |
$47K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,329 |
1,752 |
$37K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
3,251 |
1,655 |
$34K |
| 92250 |
|
643 |
632 |
$25K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
3,612 |
1,777 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
85 |
79 |
$5K |
| 92002 |
|
29 |
29 |
$1K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
154 |
79 |
$1K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
43 |
24 |
$763.04 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,839 |
4,733 |
$743.40 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
24 |
14 |
$459.56 |
| V2204 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
23 |
13 |
$300.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
698 |
354 |
$110.00 |
| 92341 |
|
387 |
380 |
$81.57 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
444 |
219 |
$78.00 |
| 92370 |
|
440 |
437 |
$45.00 |
| 92015 |
Determination of refractive state |
4,607 |
4,507 |
$0.02 |