| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,837 |
1,777 |
$137K |
| 92015 |
Determination of refractive state |
2,187 |
2,105 |
$50K |
| V2020 |
Frames, purchases |
2,558 |
2,413 |
$34K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
491 |
459 |
$31K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,405 |
1,348 |
$31K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
302 |
291 |
$27K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
877 |
770 |
$15K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
715 |
661 |
$9K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
122 |
103 |
$6K |
| 92250 |
|
131 |
125 |
$5K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
129 |
123 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
42 |
40 |
$1K |
| 92082 |
|
41 |
39 |
$422.01 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
30 |
30 |
$371.50 |
| V2702 |
Deluxe lens feature |
43 |
41 |
$11.63 |
| V2755 |
U-v lens, per lens |
45 |
44 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
16 |
16 |
$0.00 |