| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,867 |
2,715 |
$249K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,758 |
2,601 |
$194K |
| V2020 |
Frames, purchases |
5,177 |
4,719 |
$102K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
3,379 |
3,180 |
$42K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,470 |
2,248 |
$37K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,004 |
1,841 |
$33K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
871 |
810 |
$10K |
| V2799 |
Vision item or service, miscellaneous |
94 |
90 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
17 |
13 |
$647.71 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
505 |
445 |
$246.00 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
22 |
12 |
$45.00 |
| 92015 |
Determination of refractive state |
4,642 |
4,148 |
$0.00 |