| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,499 |
3,431 |
$247K |
| V2020 |
Frames, purchases |
5,091 |
4,956 |
$213K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,381 |
1,357 |
$133K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,650 |
2,597 |
$102K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,259 |
1,233 |
$47K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
3,421 |
3,355 |
$33K |
| 92015 |
Determination of refractive state |
5,401 |
5,291 |
$32K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
521 |
505 |
$15K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
90 |
88 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
32 |
29 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$546.60 |
| V2715 |
Prism, per lens |
26 |
25 |
$407.80 |