| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,118 |
4,650 |
$343K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,698 |
3,344 |
$297K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,767 |
3,296 |
$118K |
| V2020 |
Frames, purchases |
7,989 |
7,006 |
$106K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
6,375 |
5,431 |
$73K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,881 |
1,691 |
$52K |
| 92015 |
Determination of refractive state |
5,847 |
5,263 |
$49K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
353 |
271 |
$13K |
| V2799 |
Vision item or service, miscellaneous |
599 |
584 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
160 |
143 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
636 |
569 |
$6K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
25 |
13 |
$688.60 |
| 99072 |
|
179 |
158 |
$0.00 |