| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
14,363 |
13,658 |
$811K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
24,737 |
11,943 |
$711K |
| 92060 |
|
12,582 |
11,372 |
$686K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
6,024 |
5,540 |
$628K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
6,959 |
6,091 |
$502K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,877 |
3,532 |
$481K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
15,245 |
14,424 |
$314K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
11,260 |
6,843 |
$312K |
| 92015 |
Determination of refractive state |
7,596 |
6,691 |
$165K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
4,442 |
2,860 |
$135K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,849 |
2,575 |
$121K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
2,202 |
1,477 |
$78K |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
203 |
154 |
$8K |
| 92201 |
|
216 |
144 |
$3K |
| 99233 |
Prolong inpt eval add15 m |
24 |
15 |
$2K |
| 99223 |
Prolong inpt eval add15 m |
12 |
12 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
12 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$1K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
34 |
24 |
$1K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
19 |
15 |
$665.87 |
| 92226 |
|
14 |
12 |
$289.80 |