| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
915 |
826 |
$48K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
614 |
560 |
$45K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
436 |
388 |
$36K |
| 92015 |
Determination of refractive state |
1,756 |
1,605 |
$25K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
165 |
154 |
$13K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
271 |
240 |
$8K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
256 |
227 |
$7K |
| 92250 |
|
127 |
110 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
104 |
95 |
$1K |