| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
1,001 |
990 |
$301K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
5,585 |
5,484 |
$224K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
6,655 |
6,436 |
$216K |
| V2020 |
Frames, purchases |
18,593 |
17,874 |
$203K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
11,920 |
7,212 |
$176K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
3,962 |
2,549 |
$82K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
8,097 |
5,355 |
$73K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,036 |
3,944 |
$53K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,357 |
2,333 |
$52K |
| 92341 |
|
1,714 |
1,677 |
$30K |
| 92015 |
Determination of refractive state |
6,987 |
6,807 |
$25K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,076 |
1,066 |
$14K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
9,420 |
5,275 |
$12K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
151 |
146 |
$5K |
| 92226 |
|
427 |
383 |
$5K |
| 92225 |
|
383 |
356 |
$5K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
483 |
290 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
390 |
242 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
148 |
147 |
$3K |
| 92060 |
|
104 |
102 |
$2K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
96 |
95 |
$2K |
| 92201 |
|
105 |
96 |
$2K |
| 92202 |
|
153 |
136 |
$1K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
59 |
59 |
$1K |
| V2204 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
21 |
13 |
$264.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
14 |
14 |
$188.88 |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
1,872 |
930 |
$91.80 |
| 2022F |
|
27 |
26 |
$0.00 |
| V2755 |
U-v lens, per lens |
6,144 |
3,025 |
$0.00 |
| 3072F |
|
13 |
13 |
$0.00 |