| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
3,378 |
2,975 |
$106K |
| V2020 |
Frames, purchases |
3,192 |
2,625 |
$75K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,743 |
1,971 |
$59K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,816 |
2,355 |
$49K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
939 |
877 |
$47K |
| 92250 |
|
1,293 |
1,188 |
$46K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,800 |
1,445 |
$40K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
687 |
617 |
$39K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
115 |
110 |
$9K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
165 |
141 |
$7K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
207 |
180 |
$6K |
| 92341 |
|
282 |
221 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
94 |
91 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
148 |
131 |
$5K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
206 |
101 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
202 |
120 |
$3K |
| 92273 |
|
18 |
16 |
$1K |
| 99215 |
Prolong outpt/office vis |
14 |
14 |
$946.08 |