| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,834 |
3,666 |
$158K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,694 |
3,604 |
$144K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,875 |
2,205 |
$87K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,293 |
1,159 |
$56K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,054 |
2,965 |
$52K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,855 |
1,669 |
$37K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
875 |
485 |
$26K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
500 |
494 |
$21K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
634 |
513 |
$20K |
| T1015 |
Clinic visit/encounter, all-inclusive |
126 |
121 |
$17K |
| 92250 |
|
484 |
474 |
$14K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
174 |
123 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
63 |
63 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
30 |
16 |
$669.86 |
| 92341 |
|
34 |
33 |
$488.58 |