| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,181 |
3,996 |
$328K |
| V2020 |
Frames, purchases |
4,131 |
3,931 |
$267K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,439 |
1,364 |
$132K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,776 |
2,592 |
$93K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
2,877 |
2,799 |
$80K |
| 92015 |
Determination of refractive state |
5,407 |
5,167 |
$68K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
521 |
474 |
$27K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
954 |
876 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
83 |
74 |
$6K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
117 |
97 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
77 |
77 |
$2K |
| 92250 |
|
28 |
26 |
$657.08 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$357.75 |