| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
7,601 |
7,162 |
$292K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
6,462 |
6,221 |
$249K |
| 92015 |
Determination of refractive state |
8,745 |
8,189 |
$138K |
| V2020 |
Frames, purchases |
8,842 |
8,169 |
$120K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,999 |
5,542 |
$97K |
| 92310 |
|
1,631 |
1,595 |
$85K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,318 |
4,113 |
$85K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
7,746 |
7,157 |
$84K |
| 92250 |
|
2,574 |
2,421 |
$73K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,112 |
1,020 |
$60K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
897 |
824 |
$38K |
| V2303 |
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens |
856 |
760 |
$36K |
| 92342 |
|
1,275 |
1,216 |
$31K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,060 |
1,023 |
$29K |
| V2523 |
Contact lens, hydrophilic, extended wear, per lens |
1,539 |
1,504 |
$19K |
| 92225 |
|
1,134 |
1,052 |
$16K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
205 |
186 |
$10K |
| V2780 |
Oversize lens, per lens |
428 |
421 |
$8K |
| V2760 |
Scratch resistant coating, per lens |
666 |
656 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
63 |
60 |
$4K |
| V2750 |
Anti-reflective coating, per lens |
176 |
172 |
$3K |
| V2744 |
Tint, photochromatic, per lens |
76 |
75 |
$3K |
| 92202 |
|
173 |
161 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
112 |
110 |
$2K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
31 |
29 |
$1K |
| V2521 |
Contact lens, hydrophilic, toric, or prism ballast, per lens |
46 |
45 |
$866.00 |
| 92341 |
|
31 |
30 |
$767.50 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
18 |
14 |
$521.50 |
| 3072F |
|
170 |
169 |
$300.00 |
| 2026F |
|
177 |
156 |
$0.00 |