| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,535 |
2,350 |
$171K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,414 |
1,306 |
$117K |
| V2020 |
Frames, purchases |
4,307 |
3,863 |
$64K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,278 |
2,630 |
$50K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
3,824 |
3,467 |
$45K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
952 |
825 |
$14K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
226 |
168 |
$10K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
49 |
41 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
173 |
159 |
$2K |
| V2781 |
Progressive lens, per lens |
32 |
29 |
$1K |
| 92250 |
|
56 |
41 |
$1K |
| V2799 |
Vision item or service, miscellaneous |
55 |
55 |
$747.62 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18 |
13 |
$539.89 |
| 92310 |
|
28 |
24 |
$192.00 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
34 |
33 |
$103.29 |
| 92015 |
Determination of refractive state |
3,452 |
3,137 |
$0.00 |