| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,642 |
2,607 |
$130K |
| 92002 |
|
2,563 |
2,502 |
$118K |
| V2020 |
Frames, purchases |
2,788 |
2,650 |
$118K |
| 92015 |
Determination of refractive state |
10,333 |
9,860 |
$52K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
502 |
447 |
$21K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,913 |
2,900 |
$20K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
228 |
222 |
$16K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
932 |
909 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
245 |
229 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
52 |
52 |
$6K |
| 92370 |
|
354 |
329 |
$2K |
| 92250 |
|
34 |
32 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
17 |
14 |
$1K |
| V2760 |
Scratch resistant coating, per lens |
21 |
13 |
$304.28 |