| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
11,546 |
11,505 |
$521K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
6,881 |
6,866 |
$400K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,868 |
4,857 |
$343K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
6,289 |
6,190 |
$252K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
9,817 |
6,910 |
$129K |
| V2020 |
Frames, purchases |
9,557 |
9,406 |
$114K |
| 92060 |
|
2,540 |
2,520 |
$90K |
| 92202 |
|
5,139 |
3,873 |
$78K |
| 92083 |
|
1,628 |
1,611 |
$76K |
| 92225 |
|
4,065 |
2,461 |
$73K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
227 |
227 |
$67K |
| 92134 |
|
2,276 |
2,273 |
$65K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,061 |
3,056 |
$40K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,848 |
1,217 |
$39K |
| 92020 |
|
2,866 |
2,854 |
$36K |
| 92015 |
Determination of refractive state |
3,072 |
3,068 |
$36K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,135 |
1,133 |
$15K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,892 |
2,235 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
98 |
95 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
779 |
388 |
$3K |
| 92133 |
|
90 |
90 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
62 |
58 |
$1K |
| 92341 |
|
38 |
38 |
$684.00 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
12 |
12 |
$649.88 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
58 |
30 |
$480.96 |
| V2744 |
Tint, photochromatic, per lens |
12 |
12 |
$0.00 |
| V2781 |
Progressive lens, per lens |
12 |
12 |
$0.00 |