| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
14,821 |
14,733 |
$418K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,894 |
5,870 |
$391K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,870 |
4,851 |
$362K |
| 92250 |
|
11,029 |
10,997 |
$240K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
13,027 |
12,986 |
$239K |
| 92083 |
|
6,702 |
6,506 |
$221K |
| 92370 |
|
12,710 |
12,651 |
$202K |
| 92082 |
|
6,908 |
6,872 |
$175K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,589 |
2,581 |
$151K |
| 92015 |
Determination of refractive state |
15,085 |
15,027 |
$147K |
| 92285 |
|
12,053 |
10,712 |
$132K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,778 |
1,767 |
$114K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
6,418 |
6,371 |
$103K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
7,458 |
7,422 |
$78K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,387 |
1,356 |
$65K |
| 92341 |
|
2,462 |
2,448 |
$52K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,019 |
1,017 |
$47K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,276 |
3,257 |
$37K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,637 |
1,622 |
$23K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,162 |
1,157 |
$15K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
175 |
175 |
$9K |
| V2201 |
Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens |
199 |
197 |
$4K |
| 92133 |
|
214 |
214 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
43 |
43 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
149 |
149 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
968 |
956 |
$3K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
86 |
86 |
$3K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
180 |
180 |
$2K |
| 76514 |
|
86 |
84 |
$614.77 |
| 92020 |
|
56 |
54 |
$555.33 |
| 92202 |
|
61 |
60 |
$464.01 |
| V2780 |
Oversize lens, per lens |
134 |
134 |
$25.00 |
| 2026F |
|
367 |
359 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
54 |
54 |
$0.00 |
| 3072F |
|
1,696 |
1,665 |
$0.00 |
| 2033F |
|
94 |
93 |
$0.00 |