| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
14,888 |
14,480 |
$279K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
10,474 |
10,227 |
$276K |
| V2020 |
Frames, purchases |
10,306 |
10,039 |
$197K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
3,464 |
3,379 |
$192K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,695 |
3,564 |
$152K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,405 |
6,296 |
$130K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,063 |
2,034 |
$94K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,725 |
1,683 |
$87K |
| 92341 |
|
2,277 |
2,183 |
$57K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,998 |
4,945 |
$51K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
617 |
594 |
$49K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
823 |
784 |
$47K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,843 |
1,740 |
$39K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
249 |
238 |
$28K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,584 |
2,559 |
$24K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
595 |
566 |
$8K |
| 92342 |
|
273 |
261 |
$7K |
| V2303 |
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens |
230 |
223 |
$6K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
674 |
667 |
$6K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
646 |
641 |
$5K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
129 |
128 |
$1K |
| V2715 |
Prism, per lens |
214 |
209 |
$945.00 |
| V2111 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens |
13 |
12 |
$155.68 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
31 |
31 |
$120.00 |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$97.28 |