| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,309 |
3,075 |
$285K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,301 |
3,089 |
$230K |
| V2020 |
Frames, purchases |
6,847 |
6,283 |
$99K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,723 |
4,374 |
$89K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
5,968 |
5,537 |
$74K |
| 92002 |
|
442 |
427 |
$22K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
388 |
332 |
$12K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
305 |
253 |
$10K |
| 92015 |
Determination of refractive state |
2,092 |
1,925 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
635 |
597 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
293 |
280 |
$5K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
71 |
69 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
60 |
60 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
100 |
91 |
$1K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
50 |
43 |
$851.75 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
16 |
14 |
$757.46 |
| 92083 |
|
14 |
14 |
$561.21 |
| 92133 |
|
13 |
13 |
$241.88 |
| V2799 |
Vision item or service, miscellaneous |
17 |
17 |
$237.12 |