| Code | Description | Claims | Beneficiaries | Total Paid |
| 92015 |
Determination of refractive state |
7,211 |
6,363 |
$235K |
| 92250 |
|
4,397 |
3,943 |
$161K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,983 |
2,641 |
$147K |
| V2020 |
Frames, purchases |
5,491 |
4,784 |
$138K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
7,372 |
3,398 |
$100K |
| 65778 |
|
140 |
127 |
$98K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
7,242 |
3,164 |
$91K |
| 92285 |
|
3,647 |
3,298 |
$74K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,509 |
1,366 |
$69K |
| 83861 |
|
5,244 |
2,401 |
$66K |
| 92283 |
|
2,713 |
2,462 |
$51K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
889 |
782 |
$51K |
| 92226 |
|
5,042 |
2,289 |
$50K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
918 |
834 |
$48K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,607 |
2,230 |
$45K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,094 |
914 |
$35K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,924 |
1,062 |
$29K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
377 |
321 |
$28K |
| 92083 |
|
730 |
642 |
$26K |
| 92225 |
|
2,293 |
1,060 |
$25K |
| 92020 |
|
1,668 |
775 |
$19K |
| 95930 |
|
233 |
211 |
$12K |
| 92275 |
|
223 |
203 |
$12K |
| 92134 |
|
310 |
279 |
$6K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
268 |
126 |
$6K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
218 |
110 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
117 |
109 |
$4K |
| 92133 |
|
71 |
67 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
63 |
43 |
$1K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
29 |
17 |
$604.53 |
| 92341 |
|
19 |
16 |
$387.20 |