| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
4,742 |
4,613 |
$236K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,572 |
5,458 |
$194K |
| 92015 |
Determination of refractive state |
10,044 |
9,835 |
$148K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,707 |
6,603 |
$119K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,947 |
2,917 |
$106K |
| V2020 |
Frames, purchases |
8,583 |
8,410 |
$72K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,525 |
1,446 |
$54K |
| V2760 |
Scratch resistant coating, per lens |
5,737 |
5,615 |
$54K |
| 92341 |
|
1,883 |
1,808 |
$38K |
| V2755 |
U-v lens, per lens |
5,465 |
5,321 |
$34K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,843 |
3,797 |
$32K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
507 |
503 |
$23K |
| 92250 |
|
1,036 |
1,023 |
$23K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
6,005 |
5,910 |
$17K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,438 |
1,398 |
$17K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,182 |
1,173 |
$14K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
839 |
819 |
$10K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
335 |
321 |
$7K |
| 92225 |
|
501 |
494 |
$6K |
| V2204 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
209 |
206 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
28 |
27 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
39 |
37 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
51 |
47 |
$1K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
58 |
56 |
$1K |
| 3072F |
|
129 |
126 |
$920.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
97 |
96 |
$587.77 |
| 92083 |
|
13 |
12 |
$269.50 |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
19 |
19 |
$228.76 |
| 92133 |
|
13 |
13 |
$175.56 |
| V2781 |
Progressive lens, per lens |
31 |
28 |
$172.00 |
| 2022F |
|
84 |
84 |
$0.00 |