| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
4,234 |
3,739 |
$133K |
| V2020 |
Frames, purchases |
3,688 |
3,364 |
$99K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
3,538 |
3,345 |
$98K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,839 |
1,701 |
$80K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,117 |
2,872 |
$62K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,746 |
1,574 |
$44K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,237 |
1,101 |
$28K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
440 |
415 |
$27K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
520 |
464 |
$19K |
| 92341 |
|
36 |
34 |
$808.83 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15 |
13 |
$523.95 |
| 92202 |
|
70 |
64 |
$447.50 |
| 92226 |
|
25 |
13 |
$238.14 |