| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,593 |
2,520 |
$169K |
| V2020 |
Frames, purchases |
3,458 |
3,352 |
$137K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,021 |
1,980 |
$102K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
522 |
507 |
$49K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
687 |
666 |
$47K |
| V2760 |
Scratch resistant coating, per lens |
1,445 |
1,400 |
$25K |
| 92015 |
Determination of refractive state |
4,105 |
4,017 |
$24K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,538 |
1,504 |
$15K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
311 |
305 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
227 |
216 |
$7K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
48 |
45 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16 |
14 |
$489.73 |